Poster Session 4
Category: Medical/Surgical/Diseases/Complications
Poster Session 4
Allison Kurzeja, MD (she/her/hers)
MFM Fellow
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Abigail B. Clark, BS
University of Texas Southwestern Medical Center
University of Texas Southwestern Medical Center, Texas, United States
Jessica D. Sisco, MD
Resident
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Elaine L. Duryea, MD
Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Emily H. Adhikari, MD (she/her/hers)
Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Polly B. Cordova, CNM, DNP
Certified Nurse Midwife, Integrated Family Planning Opioid Project
Parkland Health
Dallas, Texas, United States
Jessica McNeil, CNM, DNP
Certified Nurse Midwife, Integrated Family Planning Opioid Project
Parkland Health
Dallas, Texas, United States
Amber Fisher
Parkland Health
Dallas, Texas, United States
Joshua Kern, MD
Assistant Professor, Department of Emergency Medicine
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Nancy S. Onisko, DO
Assistant Professor of Emergency Medicine; Assistant Director of the Perinatal Intervention Program
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Aldo Andino, MD
Assistant Professor of Emergency Medicine
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Kurt Kleinschmidt, MD
Professor of Emergency Medicine, Director of Perinatal Intervention Program
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Jessica E. Pruszynski, PhD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
C. Edward Wells, MD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
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Anne M. Ambia, MD
Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
To evaluate maternal and neonatal outcomes with a standardized, high-dose buprenorphine induction protocol for antepartum patients with opioid use disorder (OUD).
Study Design:
This was a retrospective cohort study of patients admitted with OUD who underwent an antepartum macrodose buprenorphine induction protocol. Records were reviewed for demographics, OUD treatment characteristics, maternal, obstetric, and neonatal outcomes. A descriptive and analytic statistical analysis was completed.
Results:
Between September 2023 through May 2025, 72 buprenorphine inductions occurred at a median gestational age of 17 weeks. 4 (5.6%) patients underwent buprenorphine induction but were transitioned to methadone due to persistent symptoms. The average induction dose of buprenorphine was 16mg, as per the institutional protocol (90.2%). 4 patients (5.6%) experienced precipitated withdrawal and 33 (45.8%) required additional “rescue” doses for ongoing symptoms. 47 (65.2%) remained on buprenorphine at most recent follow up. Compared to those who discontinued treatment, patients who continued had significantly fewer additional admissions for substance use disorder (0 [IQR 0-1] vs. 1 [IQR 0-2]; p< 0.001). Gestational age at delivery and birthweight were similar between patients who continued and discontinued their buprenorphine (38 weeks [IQR 37-39.5] vs. 38 weeks [IQR 36-40]; p=0.396, 32998g [IQR 2702-3526] vs.3090g [IQR 2675-3290]; p=0.218 respectively). Of patients with delivery outcomes available, more patients continuing buprenorphine were discharged with their neonate (18 (75%) vs. 7 (39%)), though this difference was not statistically significant (p=0.389).
Conclusion:
A standardized macrodose buprenorphine induction protocol successfully initiated treatment in pregnant patients with OUD. Continued buprenorphine use was associated with significantly fewer readmissions for substance use disorder, supporting its effectiveness in this vulnerable population.