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Association between medication for opioid use disorder during pregnancy and neonatal outcomes
HEAL Evaluation of Limited Pharmacotherapies for Neonatal Opioid Withdrawal Syndrome (HELP for NOWS) Consortium (2025). Association between medication for opioid use disorder during pregnancy and neonatal outcomes. Journal of Perinatology. Advance online publication. https://doi.org/10.1038/s41372-025-02442-7
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.
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