Buprenorphine versus Methadone for Opioid Use Disorder in Pregnancy 

The New England Journal of Medicine

This cohort study involving pregnant persons in the US from 2000-2018 found that buprenorphine treatment for opioid use disorder during pregnancy was associated with more favorable neonatal outcomes than methadone treatment. Neonatal abstinence syndrome occurred in 69% of the infants exposed to methadone as compared with 52% of those exposed to buprenorphine in the 30 days before delivery. An inverse association was also observed between buprenorphine exposure (as compared with methadone exposure) and preterm birth, regardless of whether exposure occurred in early or late pregnancy in both the unadjusted and adjusted analyses. Inverse associations were also observed between buprenorphine exposure (as compared with methadone exposure) and small size for gestational age and low birth weight.

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