{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T03:43:38Z","timestamp":1776311018225,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,9,1]]},"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted of 855 mother infant dyads between 1 July 2013 and 30 June 2015. Cases included all women who had exposure to buprenorphine+naloxone during pregnancy (n=62). 2 control groups were identified; the first included women with no opioid exposure in pregnancy (n=618) and the second included women with opioid exposure other than buprenorphine+naloxone (n=159). Women were excluded if they had multiple pregnancy or if they were part of a methadone programme (n=16). The majority of women came from Indigenous communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>The primary outcomes were birth weight, preterm delivery, congenital anomalies and stillbirth. Secondary neonatal outcomes included gestational age at delivery, Apgar scores at 1 and 5\u2005min, NAS Score &gt;7 and treatment for neonatal abstinence syndrome (NAS). Secondary maternal outcomes included the number of caesarean sections, postpartum haemorrhages, out of hospital deliveries and transfer of care to tertiary centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No difference was found in the primary outcomes or in the Apgar score and caesarean section rate between in utero buprenorphine+naloxone exposure versus no opioid exposure in pregnancy. Compared to women taking other opioids, women taking buprenorphine+naloxone had higher birthweight babies (p=0.001) and less exposure to marijuana (p&lt;0.001) during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Retrospective data suggest that there likely is no harm from taking buprenorphine+naloxone opioid agonist treatment in pregnancy. Larger, prospective studies are needed to further assess safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-011774","type":"journal-article","created":{"date-parts":[[2016,10,31]],"date-time":"2016-10-31T21:49:32Z","timestamp":1477950572000},"page":"e011774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Observational study of the safety of buprenorphine+naloxone in pregnancy in a rural and remote population"],"prefix":"10.1136","volume":"6","author":[{"given":"Naana Afua","family":"Jumah","sequence":"first","affiliation":[{"name":"Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Edwards","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jazmyn","family":"Balfour-Boehm","sequence":"additional","affiliation":[{"name":"Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kassandra","family":"Loewen","sequence":"additional","affiliation":[{"name":"Anishinaabe Bimaadiziwin Research Program, Sioux Lookout, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Dooley","sequence":"additional","affiliation":[{"name":"Integrated Pregnancy Program, Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianne","family":"Gerber Finn","sequence":"additional","affiliation":[{"name":"Integrated Pregnancy Program, Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Len","family":"Kelly","sequence":"additional","affiliation":[{"name":"Anishinaabe Bimaadiziwin Research Program, Sioux Lookout, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,10,31]]},"reference":[{"key":"2025121221510289000_6.10.e011774.1","first-page":"e88","article-title":"Narcotic tapering in pregnancy using long-acting morphine: an 18 month year prospective study in Northwest Ontario","volume":"61","author":"Dooley","year":"2015","journal-title":"Can Fam Physician"},{"key":"2025121221510289000_6.10.e011774.2","first-page":"11","article-title":"Achieving Cultural Safety in Aboriginal Health Services: implementation of a cross-cultural safety model in a hospital setting","volume":"6","author":"Walker","year":"2009","journal-title":"Divers Health Care"},{"key":"2025121221510289000_6.10.e011774.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2007.10.007"},{"key":"2025121221510289000_6.10.e011774.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02283.x"},{"key":"2025121221510289000_6.10.e011774.5","first-page":"52","article-title":"Feasibility and outcomes of a community-based taper-to-low-dose-maintenance suboxone treatment program for prescription opioid dependence in a remote First Nations community in Northern Ontario","volume":"9","author":"Katt","year":"2012","journal-title":"J Aborig Health"},{"key":"2025121221510289000_6.10.e011774.6","unstructured":"World Health Organization. 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