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Am J Perinatol 2020; 37(01): 073-078
DOI: 10.1055/s-0039-1698838
SMFM 2019
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Impact of Hepatitis C Virus Infection on Buprenorphine Dose in Pregnancy

Misty L. McDowell
1   Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
,
Tiffany R. Tonismae
1   Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
,
James E. Slaven
2   Department of Biostatistics, Indiana University, Indianapolis, Indiana
,
Mary P. Abernathy
1   Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
,
Anthony L. Shanks
1   Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
,
Tara D. Benjamin
3   Department of Obstetrics and Gynecology, Woman's Hospital, Baton Rouge, Louisiana
,
Sara K. Quinney
1   Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
› Author Affiliations Funding None.
Further Information

Publication History

10 June 2019

07 September 2019

Publication Date:
26 October 2019 (online)

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Abstract

Objective Buprenorphine (BUP) is commonly used for opioid maintenance therapy in pregnancy. Our goal was to determine whether liver dysfunction related to hepatitis C virus (HCV) infection impacts BUP dosing requirements in pregnancy.

Study Design This was a retrospective cohort study of pregnant women with antenatal exposure to BUP to compare dosing between individuals positive versus negative for HCV infection. Spearman correlation tests were used to assess the relationship between BUP dose and HCV status.

Results HCV infection was present in 103 (39%) of the patients. Patients with HCV infection required lower dose increases of BUP throughout pregnancy (p = 0.02). HCV viral load was positively correlated with the liver enzymes aspartate transaminase (r = 0.30, p = 0.003) and alanine transaminase (r = 0.25, p = 0.01). There was a negative correlation between HCV viral load and BUP dose during the second trimester (r = −0.27, p = 0.01) and third trimester (r = −0.20, p = 0.04).

Conclusion Women with HCV infection required less of an increase in BUP dose throughout pregnancy compared with women without HCV infection. Severity of HCV infection, as measured by viral load and liver enzymes, was also associated with BUP dosing.

Keywords

hepatitis C virus - pregnancy - buprenorphine - opiate use disorder

Note

Findings presented as a poster presentation at SMFM's 39th Annual SMFM Annual Pregnancy Meeting (Abstract, 649).