Buprenorphine improves outcomes for pregnant women with opioid use disorder

Pregnant women living with opioid use disorder (OUD) and their infants had significantly better health outcomes when treated with buprenorphine, according to a new study at Vanderbilt University Medical Center and Emory University's Rollins School of Public Health. The research will be presented at the Pediatric Academic Societies (PAS) 2025 Meeting, held April 24-28 in Honolulu. 

Pregnant women who received buprenorphine, a medication used to treat OUD, were less likely to have a preterm birth, face serious health complications, or have their infants hospitalized in the NICU compared to those who did not receive the treatment, the study found.

We know that treatment with medications like buprenorphine substantially reduces the risk of overdose death for pregnant women with opioid use disorder, but its benefits to newborns have not been well understood. We found a profound reduction in preterm birth among infants whose mothers were treated with buprenorphine, which can have a lifelong impact."

 Stephen Patrick, MD, MPH, senior author and chair of the Department of Health Policy and Management at Emory University's Rollins School of Public Health

Despite rates of OUD in pregnant women increasing more than fivefold from 1999 to 2017, more than half still do not receive treatment, researchers said. Previous research estimates that up to 20% of pregnant women with OUD may have a preterm birth, nearly double those without OUD. Preterm birth, a growing public health issue, increases the risk of health problems in children, including respiratory issues, infections, cerebral palsy, developmental delays, and vision and hearing problems.

Researchers also noted stark disparities in equitable care. Those receiving buprenorphine were significantly less likely to be Black.

"Disparities in access to buprenorphine significantly affect vulnerable populations, including pregnant women," said Sunaya Krishnapura, graduating medical student at Vanderbilt University School of Medicine and presenting author. "Our findings underscore the urgent need for policies that expand treatment access in the United States to ensure a healthy pregnancy and future for mothers and infants."

The study examined more than 14,000 pregnant women with OUD who were enrolled in Tennessee Medicaid between 2010 and 2021.