Current guidelines recommend that pregnant women with opioid use disorder be prescribed either methadone or buprenorphine, but these drugs too have significant potential for abuse. A recent study published in Acta Obstetricia et Gynecologica Scandinavica indicates that combination therapy of buprenorphine and naloxone-;which is known help to prevent such abuse-;is as safe as buprenorphine alone during pregnancy for both mother and newborn.
In the study of 67 pregnant women, the buprenorphine-naloxone and buprenorphine groups showed similar outcomes and did not significantly differ from each other in terms of maternal health during pregnancies, deliveries, or newborn health.
Combination therapy of buprenorphine and naloxone could be a choice for oral opioid maintenance treatment during pregnancy, but larger studies are needed before changing the official recommendations. Women on methadone treatment may have more severe substance abuse problems, so they require particularly cautious follow-up."
Minna M. Kanervo, Corresponding Author, Helsinki University Hospital, Finland
Kanervo, M.M., et al. (2022) Buprenorphine-naloxone, buprenorphine, and methadone throughout pregnancy in maternal opioid use disorder. Acta Obstetricia et Gynecologica Scandinavica. doi.org/10.1111/aogs.14497.