Buprenorphine vs. morphine: impact on neonatal opioid withdrawal syndrome (NOWS) outcomes in a single center retrospective study

Saminathan Anbalagan; Victoria Anderson; Michael T Favara; Daniela Stark; David Carola; Kolawole Solarin; Susan Adeniyi-Jones; Walter K Kraft; Zubair H Aghai

doi:10.1038/s41372-024-02046-7

Buprenorphine vs. morphine: impact on neonatal opioid withdrawal syndrome (NOWS) outcomes in a single center retrospective study

J Perinatol. 2024 Jul 13. doi: 10.1038/s41372-024-02046-7. Online ahead of print.

Authors

Saminathan Anbalagan^{1

2}, Victoria Anderson³, Michael T Favara⁴, Daniela Stark³, David Carola³, Kolawole Solarin³, Susan Adeniyi-Jones³, Walter K Kraft⁵, Zubair H Aghai³

Affiliations

¹ Deparment of Pediatrics/Neonatology, Thomas Jefferson University/Nemours, Philadelphia, PA, USA. sanbalagan@health.southalabama.edu.
² Deparment of Pediatrics/Neonatology, University of South Alabama, Mobile, AL, USA. sanbalagan@health.southalabama.edu.
³ Deparment of Pediatrics/Neonatology, Thomas Jefferson University/Nemours, Philadelphia, PA, USA.
⁴ Deparment of Pediatrics/Neonatology, ChristianaCare Hospital, Newark, DE, USA.
⁵ Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 39003405
DOI: 10.1038/s41372-024-02046-7

Abstract

Objectives: To compare clinical outcomes for infants with neonatal opioid withdrawal syndrome (NOWS) treated with buprenorphine or morphine.

Study design: Retrospective study of infants born ≥35 weeks' gestation and admitted to the NICU for NOWS treatment between 2011 and 2022. Length of treatment, length of stay in the hospital, and the need for secondary medications were compared between buprenorphine and morphine treated neonates. Multiple regression analysis was performed, adjusting for baseline differences and confounders.

Results: 417 neonates were treated with morphine and 232 with buprenorphine. The buprenorphine group had shorter treatment days [-10.8 days; 95% CI: -8.08 to -13.53] and shorter hospital stay [-11.8 days; 95% CI: -8.83 to -14.78]. The buprenorphine group was no more likely to receive phenobarbital or clonidine (26% vs. 29%).

Conclusion: In this large single-center study, buprenorphine was associated with shorter lengths of treatment and hospital stay in the treatment of NOWS compared to morphine.