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CME Credit Offered
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Poster Session 2

(597) A Comparison of Newborn Birthweights Between Opioid Use Disorders Treated with Methadone vs Buprenorphine

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: To determine effects of in-utero exposure to medications for opioid use disorder (MOUD) on birthweight (BW) and birthweight classification comparing methadone to buprenorphine. 

Study Design: This is a retrospective study of patients (N=362) on MOUD who delivered at a single institution between Jan 2017 and Dec 2023. Patients were divided into comparison groups based on type of MOUD: buprenorphine or methadone. Demographics and clinical outcomes including gestational age at delivery and BW were extracted from medical records. BW was categorized using Fenton 2013 Growth Charts with small for gestational age (SGA) newborns defined as a BW less than 10%ile for gestational age. Univariate and multivariable statistical analyses were done across groups with a statistical significance considered at p < 0.05. 

Results: During the study period there were 362 patients, 105 (29%) utilizing methadone and 257 (71%) utilizing buprenorphine. Groups were similar when comparing parity, maternal age, ethnicity, preterm delivery rate, mode of delivery, and concurrent psychiatric diagnosis. BW was greater in the buprenorphine group (3020±615 g) compared to methadone group (2810±586 g; p=0.003); however, there was a similar incidence of SGA newborns, 14.5% for buprenorphine vs 12.5% for methadone (p=0.61). Dosing did not affect incidence of SGA infants [Table 1]. In regression modeling, there were no independent predictors of a SGA newborn, although chronic hypertension approached significance (OR 4.30: 95% CI 0.903 to 20.485; p = 0.066) [Table 2]. 

Conclusion: When using buprenorphine or methadone for MOUD, reassurance can be provided to patients that the incidence of SGA newborns is similar, even when accounting for medical comorbidities.