(859) Weaning Buprenorphine in Pregnant Patients

334 of 456 (76%) patients were treated with buprenorphine during pregnancy. 7 of 39 (18%) of patients who weaned vs 55 of 295 (21%) controls were on MAT prior to pregnancy. The mean starting dose for buprenorphine was 10.6 mg ± 5.6 vs 10.3 mg ± 4.6, P=.76. The mean dose at delivery was 4.4 ± 4.6 mg vs 13.0 ± 4.7, P< .0001. Mean gestational age at initiation of the buprenorphine wean was 22.7 weeks. 10 of 39 (26%) who weaned were able to completely stop buprenorphine prior to delivery. Demographic data was similar including overdose history, Table 1.
NOWS treatment was lower in the weaned 23% (n=9) vs control 47% (n=137), P=.006; highest Finnegan score was lower in weaned (9.6 ± 4.5) vs control (12.3 ± 4.0), P=.0003. Birthweight percentile was higher in weaned (44.3± 29.9) vs control (34.8 ± 24.4), P=.03. Gestational age at delivery, mode of delivery, and complications at delivery did not differ between the groups, Table 2.

Conclusion: Despite counseling to stay on buprenorphine, there are patients who desire to wean. The NOWS rate in the weaned cohort was significantly lower than the controls. Patients who were weaned from buprenorphine did not have any increased maternal or neonatal morbidity. There were no maternal deaths. Larger studies are needed to evaluate this approach.