OBJECTIVES To determine the associations between trajectories of buprenorphine utilization and dose during pregnancy on maternal and neonatal health outcomes. STUDY DESIGN Retrospective cohort study among 2,925 pregnant persons with opioid use disorder, followed from the estimated start date of pregnancy through 90 days after delivery. We used administrative healthcare data from Medicaid-enrolled individuals to assess buprenorphine dose and use and maternal (postpartum buprenorphine continuation and overdose) and neonatal (low birthweight, neonatal abstinence syndrome (NAS)) outcomes. Group-based trajectory modelling was used to identify trajectories of buprenorphine dose and use during pregnancy. Weighted multivariable logistic regression assessed the association between buprenorphine trajectories and outcomes. RESULTS We identified 8 trajectories of buprenorphine utilization and dose during pregnancy. Regression analyses found that high doses of buprenorphine and a longer duration of buprenorphine use during pregnancy was associated with higher odds of postpartum buprenorphine continuation and reduced rates of overdose. Higher doses and longer duration of buprenorphine treatment were not associated with an increase in NAS or term low birth weight, relative to moderate or low doses or shorter treatment duration. CONCLUSION A longer duration and higher dose of buprenorphine treatment during pregnancy were associated with improved odds of postpartum buprenorphine continuation and were not associated with adverse neonatal outcomes.

中文翻译：

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丁丙诺啡剂量与阿片类药物使用障碍孕妇结局之间的关联。


目的 确定妊娠期丁丙诺啡使用轨迹和剂量对孕产妇和新生儿健康结局的相关性。研究设计 对 2,925 名患有阿片类药物使用障碍的孕妇进行回顾性队列研究，从预计的怀孕开始日期到分娩后 90 天。我们使用了来自医疗补助入组个体的行政医疗保健数据来评估丁丙诺啡的剂量和使用以及孕产妇 （产后丁丙诺啡继续使用和过量） 和新生儿 （低出生体重、新生儿戒断综合征 （NAS）） 结局。基于组的轨迹模型用于确定丁丙诺啡剂量和妊娠期间的使用情况。加权多变量 logistic 回归评估丁丙诺啡轨迹与结局之间的关联。结果 我们确定了怀孕期间丁丙诺啡使用和剂量的 8 种轨迹。回归分析发现，高剂量丁丙诺啡和怀孕期间使用丁丙诺啡的时间较长与产后继续使用丁丙诺啡的几率较高和过量服用率降低有关。相对于中等或低剂量或较短的治疗持续时间，较高剂量和较长的丁丙诺啡治疗持续时间与 NAS 或足月低出生体重的增加无关。结论 妊娠期较长、剂量较高的丁丙诺啡治疗与产后继续使用丁丙诺啡的几率增加相关，与不良新生儿结局无关。