Association between medication for opioid use disorder during pregnancy and neonatal outcomes

Objective: Evaluate associations between antenatal exposure to medication for opioid use disorder (MOUD), including MOUD type, and neonatal outcomes for infants with neonatal opioid withdrawal syndrome (NOWS). Study design: Data from 768 neonates with NOWS born between 36-0/7 to 41-6/7 weeks gestation were retrospectively collected from 13 United States hospitals. Results: Compared to neonates with antenatal exposure to non-MOUD opioids, neonates with antenatal exposure to MOUD opioids had a 51% lower odds of delivery before 39 weeks and 2.72-fold greater odds of breastfeeding. Compared to neonates with antenatal exposure to prescribed methadone, neonates exposed to prescribed buprenorphine or buprenorphine/naloxone had increased mean head circumference z-scores (0.31 and 0.48 units respectively), decreased odds of pharmacologic treatment (49% and 58%, respectively), and a reduced mean length of hospital stay (35% and 39%, respectively). Conclusion: Antenatal exposure to MOUD opioids, specifically prescribed buprenorphine, was associated with significantly improved neonatal outcomes. ClinicalTrials.gov