Researchers from Rutgers Health and Harvard Medical School have conducted a study indicating fewer congenital defects in children born to mothers treating opioid use disorder with buprenorphine rather than methadone during the first trimester of pregnancy.
Building on previous research showing fewer preterm births and withdrawal symptoms in children of buprenorphine users, the study supports the use of buprenorphine as a primary treatment option for pregnant individuals dealing with opioid use disorder. However, the findings don’t recommend switching from methadone to buprenorphine during pregnancy due to potential side effects and relapse risks.
Elizabeth Suarez, a pharmacoepidemiologist at the Rutgers Institute for Health, Health Care Policy, and Aging Research, and lead author of the study, emphasized the complexity of choosing treatments for opioid use disorder during pregnancy. Suarez stated, “If you are already stably controlled on methadone prior to pregnancy, it’s not recommended that you switch because of these findings because buprenorphine just doesn’t always work as well for patients, and switching medications adds risks. This is just one piece of the puzzle in terms of trying to think about which medication to use.”
The study, based on extensive Medicare utilization data covering 13,360 pregnancies and one month post-delivery, linked parental and newborn records to assess the association between buprenorphine or methadone use and congenital malformations. Adjusted figures revealed that first-trimester buprenorphine exposure was linked to an 18% lower risk of all malformations compared to methadone, along with lower risks of specific malformations, including cardiac, clubfoot, and oral cleft.
Suarez highlighted the significance of the study’s large dataset, allowing for detailed analyses of specific malformations. The research contributes valuable insights into treatment choices for opioid use disorder during pregnancy, emphasizing the need for a nuanced approach based on individual patient needs.
