174: A comparison of neonatal outcomes in opioid dependent mothers with a history of substance abuse versus chronic pain

To assess outcomes of infants born to opioid dependent mothers receiving either methadone or buprenorphine for the treatment of substance abuse versus chronic pain. We retrospectively reviewed all maternal and neonatal records of pregnancies maintained on buprenorphine or methadone therapy at our institution since 2005. All patients underwent full psychiatric evaluation and were diagnosed with either substance abuse or chronic pain. Fifty-four mother/neonate pairs on either methadone or buprenorphine therapy were identified. Twenty-seven patients (50.0%) were on methadone therapy and twenty-seven (50.0%) were on buprenorphine therapy. Eighteen (33.3%) patients were diagnosed with chronic pain and thirty-six (66.6%) were diagnosed with substance abuse. There was no statistical difference in mean birth weight, head circumference, length, or Apgar scores in women with a history of substance abuse versus chronic pain. Overall, twenty-seven neonates (50.0%) were diagnosed with neonatal abstinence syndrome (NAS), of which twenty-three (85.1%) required treatment. Although the proportion of babies who required treatment for NAS did not differ between the groups, neonates of mothers with a history of substance abuse had a significantly longer stay in the neonatal intensive care unit compared to neonates born to mothers with a history of chronic pain. (23.5 days 13.6 v. 8.4 days 5.1, p <0.0004). Neonates born to opioid-dependent women with a history of substance abuse require longer treatment for neonatal abstinence syndrome compared to those born to women with chronic pain.