Using Naltrexone During Pregnancy Can Benefit Infants, Moms

Using naltrexone to treat pregnant women who have opioid use disorder can benefit both mother and child and reduce the chances of neonatal abstinence syndrome (NAS), according to a study released this week. 

The study, published in the journal Clinical Therapeutics, compared outcomes for mothers and babies when the mothers were treated with naltrexone (known by the brand name Vivitrol), compared with a group of mothers who were treated with buprenorphine.

Naltrexone vs. Buprenorphine

The study was small, with just six mothers treated with naltrexone and 12 treated with buprenorphine. However, the results were powerful. They showed that none of the infants whose mothers had been treated with naltrexone experienced neonatal abstinence syndrome.

On the other hand, 92% of the infants whose mothers used buprenorphine showed signs of neonatal abstinence syndrome, and 46% required medications to treat their withdrawal symptoms. 

Eighty-three percent of mothers treated with naltrexone were able to initiate breastfeeding. 

The study also found that naltrexone was more effective at preventing overdose during pregnancy, which is one of the biggest risk factors for the health of women and their fetuses.

All of the women taking naltrexone abstained from illicit opioid use during their pregnancy, but 23% of the women being treated with buprenorphine relapsed during their pregnancy. The authors noted in a news release that the most important aspect of treating opioid use disorder during pregnancy is keeping the mothers stable on their medication to decrease any risk of relapse.

“While these study results are preliminary, the outcomes we observed for both mother and baby when naltrexone is used to treat opioid use disorder during pregnancy are promising,” said study author Dr. Elisha Wachman, a neonatologist at Boston Medical Center. 

Wachman said that there needs to be more study that compares long-term outcomes.

“Our findings support the need for a larger multi-center study examining the long-term maternal and child safety and efficacy outcomes of naltrexone during pregnancy,” she said. “If those studies yield positive outcomes for both mother and baby, continuing women on naltrexone during their pregnancy could be another safe approach to treat opioid use disorder.”

Over the past 10 years, the number of babies born dependent on opioids has increased five-fold. For these infants, the symptoms of neonatal abstinence syndrome appear in the first few days of life, and can include trouble eating, muscle rigidity, and an inability to be soothed.

Up to 80% of babies born with neonatal abstinence syndrome require medications—including morphine, methadone and buprenorphine—to treat their symptoms.