Buprenorphine and buprenorphine/naloxone are commonly used to treat opioid use disorder (OUD).1 The American College of Obstetricians and Gynecologists (ACOG) and the Substance Abuse and Mental Health Services Administration (SAMHSA) recommend medication-assisted treatment for pregnant patients with OUD to increase the likelihood of a healthy birth and to reduce the risk for potential relapse of opioid use.1
To measure the effect of buprenorphine and buprenorphine/naloxone on birth outcomes, we analyzed 69,167 births to mothers who had an OUD diagnosis during pregnancy. We excluded patients prescribed methadone or naltrexone.
We found that pregnant women with OUD prescribed buprenorphine starting in the first trimester of pregnancy were 6% less likely to have a baby who had a NICU admission, 27% less likely to have a baby with low birth weight, and 36% less likely to have a premature birth than patients who were prescribed neither buprenorphine nor buprenorphine/naloxone. Women prescribed buprenorphine/naloxone starting in the first trimester of pregnancy were 8% less likely to have a baby who had a NICU admission, 20% less likely to have a baby with low birth weight, and 24% less likely to have a premature birth than patients who were prescribed neither buprenorphine nor buprenorphine/naloxone. Patients prescribed one of these medications starting in the second or third trimester had similar risk to those who were not prescribed one of these medications. We did not find a meaningful difference in these pregnancy outcomes between patients prescribed buprenorphine and patients prescribed buprenorphine/naloxone.
Our findings align with previous studies that suggest medications for opioid use disorder (MOUD) are associated with improved birth outcomes2,3 and add to the understanding of how the timing of prescription may be correlated with these improvements.
