Two major studies shed light on opioid treatment during pregnancy and postpartum, examining the long-term safety for children and the factors that keep mothers in care.
Neurodevelopmental Outcomes: No Increased Risk Found
A large-scale study published in the BMJ on April 15, 2026, provides important reassurance regarding the safety of common treatments for opioid use disorder during pregnancy.
The study found no increased risk of long-term adverse neurodevelopmental outcomes for children exposed to buprenorphine compared with those exposed to methadone.
Led by Dr. Sabine Friedrich, formerly of Mass General Brigham, the research drew on nationwide data to compare the two medications. The authors state that the findings should reassure providers and individuals considering these two treatment options during pregnancy.
Background on MOUD Use in Pregnancy:
- Medications for opioid use disorder (MOUD) during pregnancy are associated with improved outcomes, including reduced risk of maternal overdose and preterm birth.
- Both buprenorphine and methadone are recommended, though methadone often requires daily clinic visits while buprenorphine can be prescribed.
- Previous research comparing the long-term neurodevelopmental impact of these two drugs on children has been limited.
Opioid Treatment Retention in New South Wales
A separate population-based study in New South Wales, Australia (2004–2021) examined treatment engagement among 5,212 women with a history of treated opioid dependence.
While most women remained in treatment, specific subgroups were identified as needing additional support.
Key Findings on Retention- Three in four women received methadone or buprenorphine during pregnancy.
- From 2005 to 2021, methadone use declined from 71% to 37%, while buprenorphine use increased from 12% to 29%.
- 84% of women receiving treatment during pregnancy remained in treatment until childbirth.
- Of women receiving treatment at the time of birth, 79% continued treatment for one year after birth.
The study identified several factors associated with a higher likelihood of dropping out of treatment:
Women who initiated treatment after becoming pregnant were less likely to remain engaged through childbirth or the first postpartum year, compared with women who were already in treatment at conception.
- Women receiving buprenorphine were more likely to discontinue treatment than those receiving methadone.
- Women initiating treatment while in custody also faced higher discontinuation rates.
- Those with co-occurring mental health conditions were more likely to stop treatment.
Implications: The findings suggest that while most opioid-dependent women remain engaged in treatment during pregnancy and the first postpartum year, targeted support is needed for subgroups at risk of dropping out.