In the naltrexone group, the rate of NAS in neonates > 34 weeks was significantly lower (10/119 [8.4%] vs 79/105 [75.2%]; P < .0001). The only significant factor for the rate of NAS, according to multivariate analysis, was the form of MAT. In the naltrexone group, 87 patients took the drug up to delivery and none of the neonates had NAS.
Looking at maternal outcomes, the authors found that no relapses occurred in the 7-day no-treatment window before initiation of naltrexone. Neither group experiences any spontaneous abortions or stillbirths. No changes in FHR tracings were seen on initiation of naltrexone at ≥ 24 weeks’ gestation.
No differences in incidence of birth anomalies were seen between the naltrexone and standard-care groups. Umbilical cord blood and maternal levels of naltrexone and 6-beta-naltrexol matched; no levels were elevated, and values were undetected if naltrexone was discontinued > 60 hours before delivery.
“This prospective study now shows,” the authors said, “that naltrexone MAT is a viable option for some women it they are successful at complete opioid detoxification. Additionally, for those pregnant patients who already are receiving naltrexone therapy at the start of pregnancy, continuing naltrexone MAT can also be an option.” The researchers noted, however, that long-term follow-up of these mothers and infants is needed to compare their progress with that in mother/child pairs exposed to MAT and who receive no opioids at delivery.