Date of Award

5-2020

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Russell Kauffman

Keywords

buprenorphine in pregnancy, buprenorphine-naloxone in pregnancy, naloxone in pregnancy, buprenorphine safety, suboxone, Subutex, buprenorphine and neonatal abstinence syndrome, pain management buprenorphine, peripartum pain management buprenorphine.

Abstract

Opioid use disorder during pregnancy has continued to rise, and more primary care providers are being encouraged to prescribe opioid agonist pharmacotherapy. Such medications include methadone, buprenorphine, and naloxone. Many studies have been done to compare these medications’ role in medication assisted treatment (MAT) in pregnant women with opioid use disorder. The purpose of this literature review is to compare the use e of buprenorphine, with and without naloxone, as MAT for opioid dependent pregnant women. Specific outcomes compared in this study include maternal and neonatal safety, neonatal abstinence syndrome, and peripartum pain management. This review included three electronic search databases: PubMed, Clinical Key, and Cochrane library from September 1, 2019 to March 1, 2020. The search included randomized control trials, systematic reviews, and meta-analysis that were published in the last 25 years. Several of the presented studies show evidence to support of buprenorphine monotherapy and buprenorphine-naloxone combination therapy. Majority of the research suggest overall insufficient evidence to declare one therapy superiority compared to the other. Many studies discuss the complications and limitations with regards to medication trials in pregnant and opioid dependent populations. Ultimately, more research and clinical trials are needed in order to claim the safety and efficacy in the use of buprenorphine as MAT in pregnant women with opioid dependence.

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