Study: Treating Opioid Use Disorder in Pregnancy with Buprenorphine Improves Maternal, Infant Health
By Ellie Pourbohloul
A new study in JAMA Health Forum from researchers at Emory University’s Rollins School of Public Health and Vanderbilt University School of Medicine found that pregnant women with opioid use disorder (OUD) who received buprenorphine treatment had lower rates of adverse outcomes compared to those who did not receive treatment.
The study used Medicaid claims data to assess health outcomes for 14,463 pregnant women diagnosed with OUD, 51.6%of whom received buprenorphine during pregnancy.
Researchers found these women had a reduced rate of major pregnancy-related health complications as well as a reduced rate of preterm birth, which occurs when a baby is born before 37 weeks of pregnancy.
Previous studies found an association between opioid use disorder during pregnancy and risk of preterm birth, affecting as much as one in five pregnancies with opioid use disorder.
“Preterm birth is a major public health concern in the United States,” says lead author Sunaya R. Krishnapura, a graduating medical student at Vanderbilt University School of Medicine. “Preterm birth, which complicated 10.4% of all births in 2022, can lead to long-term health issues for infants, including respiratory issues, vision issues, and developmental delays.”
Key Takeaways
- Researchers found a significantly lower rate of adverse pregnancy outcomes among mother-infant pairs treated with buprenorphine. The estimated risk of adverse outcomes was 23% for those treated with buprenorphine, compared to 28.1% for those who were not.
- Infants of mothers treated with buprenorphine had a significantly lower rate of being born preterm, with an estimated risk of 7% in the treated group compared to 17% in the untreated group.
- The treatment group also had a lower rate of life-threatening complications—such as sepsis, kidney failure, and heart failure—as well as lower rates of NICU admissions.
Why This Matters
The study comes at a time when policies addressing opioid use disorder and maternal health are receiving increased attention, and as pregnant women face significant barriers to treatment access. According to a previous study from the group, they are less likely than nonpregnant women to receive an appointment for treatment of opioid use disorder. In addition, at least 50% of pregnant women with opioid use disorder do not receive treatment nationwide.
In many states, pregnant women with OUD face structural and social barriers to accessing treatment—including limited provider availability in rural areas, stigma, and concerns about legal consequences.
“Our findings suggest that reducing these barriers that are currently in place for pregnant women and expanding access to treatment through health policy initiatives can lead to improved health outcomes,” Krishnapura says.“Additionally, our findings have significant implications for the health of mothers and infants. If we can intervene early and reduce the risk of adverse outcomes for infants as well as mothers during pregnancy, we can create long-lasting positive impacts on the health of these mothers and infants going forward.”
“Nationwide, pregnant women face substantial barriers to getting treatment for opioid use disorder—and as a result,we’ve seen increases in overdose deaths before and after they deliver their babies,” says senior author Stephen Patrick, MD, chair of the Department of Health Policy and Management at Rollins and practicing neonatologist at Children’s Healthcare of Atlanta. “There is a surprising lack of data comparing buprenorphine—the most common treatment for opioid use disorder—with no treatment. We found that the benefits of treatment were profound, substantially reducingrisk of preterm birth and severe maternal morbidity.”
