With the opioid crisis in the United States, we have seen increasing rates of opioid use across multiple sectors of our population, including women of reproductive-age. The risks of opioid use are significant, especially during pregnancy, when opioid use is associated with higher risk of pregnancy loss, adverse pregnancy outcomes, and neonatal abstinence syndrome.
In 2017, approximately 8.2 per 1000 deliveries were affected by opioid use disorder in this country, with even higher rates observed in women who were publicly insured, with an estimated 14.6 per 1000 deliveries affected. Standard care for treating opioid use disorder during pregnancy is opioid agonist therapy with either buprenorphine or methadone.
Medication treatment of opioid use disorder during pregnancy has unequivocal benefits and is associated with improved adherence to prenatal care, lower incidence of preterm birth, reduced recurrence of opioid use, and decreased risk of opioid overdose and death from opioid overdose. Traditionally