Buprenorphine for Opioid Use Disorder in Pregnancy Can Improve Outcomes

Buprenorphine linked to reduced rate of adverse outcomes, including severe maternal morbidity, NICU admissions, and preterm births

By Elana Gotkine HealthDay Reporter

FRIDAY, May 2, 2025 (HealthDay News) — For mothers with opioid use disorder (OUD), treatment with buprenorphine in pregnancy is associated with improved maternal and infant outcomes, according to a study published online April 27 in JAMA Health Forum to coincide with the annual meeting of the Pediatric Academic Societies, held from April 24 to 28 in Honolulu.

Sunaya R. Krishnapura, from the Vanderbilt University School of Medicine in Nashville, Tennessee, and colleagues conducted a retrospective cohort study involving maternal-infant dyads enrolled from 20 weeks of estimated gestational age to six weeks postpartum between 2010 and 2021 to examine whether treatment of OUD with buprenorphine is associated with improved maternal and infant outcomes compared with no treatment.

Overall, 51.6 percent of the 14,463 maternal-infant dyads received buprenorphine treatment. The researchers found that compared with untreated dyads, dyads treated with buprenorphine had a significantly lower rate of adverse pregnancy outcomes (25.4 versus 30.8 percent). Lower rates of severe maternal morbidity (SMM) events (5.4 versus 6.9 percent), preterm births (14.1 versus 20.0 percent), and neonatal intensive care unit (NICU) admissions (15.2 versus 17.2 percent) were also seen for the treatment group. Those with buprenorphine treatment had a 5.1 percentage point lower probability of any adverse outcomes in adjusted analyses, including a 1.2, 1.7, and 5.3 percentage point lower probability of SMM, NICU admission, and preterm birth, respectively. To avoid an adverse pregnancy outcome, the number needed to treat was 20.

“We found that buprenorphine use in pregnancy was associated with improvements in pregnancy and infant outcomes, underscoring the need for OUD treatment expansion in the United States,” the authors write.

One author disclosed ties to the publishing industry.