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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(397) Increased Buprenorphine Dosing Frequency Was Not Associated With An Increase In Neonatal Opioid Withdrawal Syndrome

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: Pregnancy alters the pharmacokinetics of buprenorphine with the need for increased dosing frequency to stay in the therapeutic range. We sought to evaluate whether increased dosing frequency is associated with an increased risk of Neonatal Opioid Withdrawal Syndrome (NOWS).

Study Design: This study was from a longitudinal cohort of pregnant persons receiving prenatal care through a multidisciplinary program for substance use disorder (SUD) between 2015 and 2024. We compared outcomes between patients prescribed once-a-day (QD) dosing verses twice a day (BID) or greater dosing of buprenorphine. Women not taking buprenorphine at delivery were excluded as well as those with less than 6 visits. Fisher’s exact and two-sample t-tests were used for our statistical analysis.

Results: 367 patients were included, with 266 (72.5%) receiving QD dosing versus 101 (27.5%) dosed BID or more.  Demographics were similar between groups including tobacco use. There was no significant difference in gestational age at delivery (38.4 +/- 2.2, 38.1 +/- 1.9;, p=0.25), rate of preterm birth (9.4%, 12.9%, p=0.34), birthweight percentile (37.6 +/- 25.5, 32.5 +/- 22.7, p=0.08), rate of NOWS (48.9%, 45.5%, p= 0.68), length of hospital days (11 [6 to 20.2], 13 [6 to 20.0], p= 0.37) or NOWS treatment days (15 [10 to 20], 14 [11 to 24], p=0.28).

Conclusion: An increase in dosing frequency was not associated with an increased risk of NOWS. Our data suggests that providers may be able to dose buprenorphine based on patient’s needs (cravings and withdrawal symptoms) without concern of increasing the risk of NOWS.