Opioid use disorder during pregnancy

Opioid Use Disorder (OUD) during pregnancy has a range of serious potential impacts upon mother and baby. Preterm labor, fetal convulsions, intrauterine fetal death, and intrauterine meconium passage, as well as fetal distress and withdrawal also arise in the context of repeated daily cycles of maternal opioid use and withdrawal, contributing to issues such as intrauterine growth restriction, placental abruption, preterm delivery, and low birth weight. Pregnant women are more likely to initiate treatment for OUD and remain abstinent when permitted to stay with their child(ren), and thus pregnancy actually presents a an opportunity for intervention. OUD treatment options regarded as the standard of care use medication-assisted treatment (MAT) with either buprenorphine or methadone, improving maternal and neonatal outcomes. A recent review has addressed management of OUD during pregnancy and after parturition: this comprehensive discussion addressed treatment options & decisions, substance use screening, dosing modifications, peripartum care. The full text of the review is available here.