Buprenorphine Decreases Fetal Breathing Movements in Fetal Biophysical Profile Assessment

INTRODUCTION Ten percent of pregnant patients in our community receive medication-assisted therapy with buprenorphine during their prenatal course. The American College of Obstetricians and Gynecologists (ACOG) recommends antenatal testing for conditions when risk of stillbirth is greater than 0.8/1,000. Opioid use in pregnancy is associated with modest increased odds of stillbirth (odds ratio 1.3). Our hypothesis was that biophysical profile (BPP) in buprenorphine patients might be different than a control group of high-risk patients due to the effects of buprenorphine. METHODS This retrospective chart review analyzed the BPP assessments of patients receiving buprenorphine compared to patients followed for chronic hypertension. Patients seen between July 1, 2016, and June 30, 2020, were evaluated. 131 patients were in the buprenorphine group and 46 patients were in the chronic hypertension control group.RESULTS Patients receiving buprenorphine were more likely to have a fetal breathing score of zero than patients undergoing BPP for hypertension. There is a significant relationship between buprenorphine dosage and breathing motion assessment. Chi-squared test yielded a value of P =.04269. Patients on high-dose buprenorphine are more likely to have values of 0 on fetal breathing motion assessment than low-dose patients.CONCLUSION This is the first study to show a dose-related effect of buprenorphine on fetal breathing movements. Previous research has shown buprenorphine effects on fetal brain structure. Current guidelines minimize the effects of maternal buprenorphine administration on fetal development. This study adds to prior research; further study on the dose-related long-term and short-term effects of buprenorphine on fetal development is encouraged.