Buprenorphine and Methadone Discontinuation During Pregnancy and the Postpartum Period: A Nationwide Cohort Study.

Objective: Treatment of pregnant patients with opioid use disorder with methadone or buprenorphine is crucial for maternal and neonatal safety. While several clinical trials have demonstrated higher treatment discontinuation rates for buprenorphine compared with methadone outside of pregnancy, evidence during pregnancy and the postpartum period is limited. The authors compared treatment discontinuation between buprenorphine and methadone during pregnancy and over follow-up through 1 year postpartum.

Discontinuation of treatment for alcohol use disorder during pregnancy and postpartum in the United States.

Background: The degree of alcohol use disorder (AUD) treatment utilization during the perinatal period is unknown. We report the prevalence of preconception receipt of medications for AUD (MAUD) and psychosocial interventions (PSY), discontinuation during pregnancy, and postpartum resumption in a multi-state sample, comparing pregnant and nonpregnant people with AUD.

Methods: Using MarketScan combined commercial and Medicaid claims (2016-2019), we identified individuals with AUD who had continuous insurance coverage throughout pregnancy, classifying those with a live birth as pregnant, and compared their MAUD and PSY patterns to nonpregnant peers matched by age, insurance type, and calendar time.

Impact of prenatal tobacco exposure on brain structure and function in offspring: a systematic review and meta-analysis of MRI findings.

Purpose: The increasing global prevalence of maternal smoking during pregnancy raises concerns about lasting effects on fetal neurological development. This review of brain magnetic resonance imaging studies aims to analyze existing literature on the influence of maternal prenatal tobacco exposure on the structure and function of the offspring's brain.

Methods: A systematic search was conducted in PubMed, Web of Science, and Embase for relevant articles published before May 24, 2025.

Connecticut's Novel Prenatal Substance Exposure Policy Is Associated With Declining CPS Reports And Foster Placements.

In 2019, Connecticut became the first state to implement a deidentified notification policy for infants with prenatal substance exposure in response to updated provisions contained in the federal Child Abuse Prevention and Treatment Act (CAPTA) of 1974. Our study aimed to test whether Connecticut's notification policy was associated with an increase in Child Protective Services (CPS) interactions for this population. We analyzed child welfare and vital records over the course of a sixty-six-month time frame starting two years before the policy took effect.

Factors Associated with Positive Toxicology at Delivery: Insights From the University of Maryland Medical System.

Objective: To explore factors associated with positive toxicology tests during birthing admissions within a hospital system employing universal toxicology testing.

Methods: A retrospective cross-sectional study from 2019 to 2022, within a health system where toxicology tests are performed routinely during the birth admission. Substance use was defined as a positive toxicology test and race was self-reported.

Experiences of healthcare discrimination and treatment outcomes among pregnant and postpartum people with opioid use disorder.

Introduction: Experiences of discrimination among pregnant and postpartum people with opioid use disorder likely affect utilization of medications for opioid use disorder (MOUD), which reduce the risk of overdose and death. We evaluated experiences of discrimination in this population by healthcare setting and estimated their effects on MOUD treatment outcomes.

Methods: Participants who had received MOUD at least once during pregnancy were enrolled into this retrospective cohort study.

Privacy and Digital Health: Causes for Concern and a Way Forward.

Digital health technologies hold promise for addressing substance use disorder (SUD) treatment gaps but also introduce significant privacy risks, challenging patient autonomy and therapeutic trust. This commentary highlights how SUD digital health services, despite claims of "privacy" and "HIPAA compliance," often utilize surveillance technologies that enable widespread data sharing, including sensitive health information and location data, with third parties, often without informed consent. This is particularly concerning as individuals seeking addiction treatment share highly sensitive data that, once outside the controlled medical and research setting, can lead to discrimination, legal risks, and algorithmic profiling.

Split-dosing of Methadone During Pregnancy and Postpartum Period: A Systematic Review of Outcomes.

Objectives: The primary objective of this study is to conduct a systematic review of the scientific literature on the practice of methadone split-dosing, where the total daily dose is divided into 2 or more doses taken 10-12 hours apart rather than administered as a single daily dose. The review aims to evaluate the perinatal effects of this dosing regimen on maternal, fetal, and neonatal outcomes.

Methods: A systematic review was conducted by searching 6 databases, including APA PsycInfo, the Cochrane Library, CINAHL, Embase, PubMed, and Scopus, through the last search date of June 13, 2023.

Consensus statement on pain management for pregnant patients with opioid use disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine.

Pain management in pregnant and postpartum people with an opioid use disorder requires a balance among the risks associated with opioid tolerance, including withdrawal or return to opioid use, considerations around the social needs of the maternal-infant dyad, and the provision of adequate pain relief for the birth episode that is often characterized as the worst pain a person will experience in their lifetime. This multidisciplinary consensus statement from the Society for Obstetric Anesthesia and Perinatology, the Society for Maternal-Fetal Medicine, and the American Society of Regional Anesthesia and Pain Medicine provides a framework for pain management in obstetrical patients with opioid use disorder. The purpose of this consensus statement is to provide practical and evidence-based recommendations and is targeted to healthcare providers in obstetrics and anesthesiology.

The Impact of Frequency of Cannabis Use on Hypertensive Disorders During Pregnancy.

Objectives: Cannabis is 1 of the most commonly used substances during pregnancy, and there is mixed evidence of its impact on maternal outcomes, such as hypertensive disorders. Prior research on cannabis use during pregnancy has not accounted for use frequency, which might explain mixed results across studies. The objective of this study was to examine how frequencies of use during pregnancy are associated with hypertensive disorders.

Managing Bias in the Care of Pregnant and Parenting People with Substance Use Disorder.

Introduction: Unintentional overdose is the leading cause of pregnancy-associated death in Maryland and is preventable. Stigma contributes to birthing peoples' disengagement with the health care system, and health care professionals may participate in stigmatizing processes. We aimed to develop and evaluate a training on stigma and bias related to substance use disorder (SUD) for maternal health care professionals in Maryland.

Racial and Ethnic Inequities in the Receipt of Medications to Treat Opioid Use Disorder Among Pregnant People: A Meta-analysis.

Objectives: The aim of this meta-analysis is to examine inequities in the receipt of medications for opioid use disorder (MOUD) by race and ethnicity among pregnant people.

Methods: PubMed and Embase were searched for studies examining the relationship between race and ethnicity and the receipt of MOUD during pregnancy. Studies were included if they were observational in nature and reported sufficient data to ascertain effect measures.

Perinatal Substance Use-Related Content at Major Addiction Scientific Conferences: An Analysis of Oral Presentation Sessions.

Background: Substance use is a leading cause of pregnancy-associated death in the US. It is not known if the amount of perinatal content at national addiction science conferences reflects the research and education being done in this area nationally.

Methods: We analyzed oral presentation sessions at five major addiction scientific conferences from 2021 to 2023 (American Academy of Addiction Psychiatry [AAAP], American Society of Addiction Medicine [ASAM], Association for Multidisciplinary Education and Research in Substance use and Addiction [AMERSA], College on Problems of Drug Dependence [CPDD], Research Society on Alcohol [RSA]) closely affiliated with organizations involved with substance use-related research and funding.

A cross-sectional study of differences in medication for opioid use disorder receipt among pregnant people enrolled in Medicaid in Oregon, United States.

Background And Aims: Medication is the gold standard to support a healthy pregnancy for pregnant people with opioid use disorder (OUD). This study measured inequities and differences in OUD medication treatment among pregnant people in Oregon, USA.

Design, Setting, Participants And Measurements: Our study population consisted of Medicaid enrollees across the US state of Oregon who had at least one live hospital birth between 2012 and 2020 and one diagnosis of OUD prenatally (n = 4363).

Lessons from Maternal Mortality Reviews. How Addiction Care Providers can help improve Outcomes for Pregnant, Postpartum, and Parenting people.

Background: Drug-related deaths, including accidental and intentional overdose and other drug-related causes, are among the leading causes of maternal mortality in the United States.

Analysis: Addiction care providers can contribute to efforts to decrease maternal mortality related to substance use disorder. In this report, we review current research to inform the care of pregnant and parenting people with substance use disorder (SUD) to address rising drug-related deaths.

Using ICD Codes Alone May Misclassify Overdoses Among Perinatal People.

Introduction: As perinatal drug overdoses continue to rise, reliable approaches are needed to monitor overdose trends during pregnancy and postpartum. This analysis aimed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of ICD-9/10-CM codes for drug overdose events among people in the MATernaL and Infant clinical NetworK (MAT-LINK) with medication for opioid use disorder during pregnancy.

Methods: People included in this analysis had electronic health record documentation of medication for opioid use disorder and a known pregnancy outcome from January 1, 2014, through August 31, 2021.

Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine.

Pain management in pregnant and postpartum people with an opioid-use disorder (OUD) requires a balance between risks associated with opioid tolerance, including withdrawal or return to opioid use, considerations around social needs of the maternal-infant dyad, and the provision of adequate pain relief for the birth episode that is often characterized as the worst pain a person will experience in their lifetime. This multidisciplinary consensus statement between the Society for Obstetric Anesthesia and Perinatology (SOAP), Society for Maternal-Fetal Medicine (SMFM), and American Society of Regional Anesthesia and Pain Medicine (ASRA) provides a framework for pain management in obstetric patients with OUD. The purpose of this consensus statement is to provide practical and evidence-based recommendations and is targeted to health care providers in obstetrics and anesthesiology.

Services for perinatal patients with opioid use disorder: a comprehensive Baltimore City-wide 2023 assessment.

Background: Overdose is a leading cause of maternal mortality; in response, maternal mortality review committees have recommended expanding substance use disorder (SUD) screening, improving collaboration between obstetric and SUD treatment providers, and reducing fragmentation in systems of care. We undertook an analysis of the perinatal SUD treatment landscape in Baltimore, Maryland in order to identify barriers to treatment engagement during pregnancy and the postpartum period and guide system improvement efforts.

Methods: We conducted a survey of seven birthing hospitals, 31 prenatal care practices, and 108 SUD treatment providers in Baltimore from April-June 2023.

"We're Checking a Box and, You Know, Covering Our Own": Health Professionals' Descriptions of Hospital-Policy Making Regarding Child Welfare Reporting Related to Birthing People's Drug Use.

Background: Hospital policies play a role in healthcare providers' decision-making about reporting birthing people who use drugs to child welfare. This study sought to understand how these specific hospital policies are made.

Methods: We conducted semi-structured interviews with healthcare professionals involved in developing or revising hospital policies related to child welfare reporting for birthing people who use drugs.

Adverse Events at 1 Month Following Medication Initiation for Opioid Use Disorder Among Adolescents and Young Adults.

Background: We assess adverse events (AEs) following medication initiation for adolescents and young adults with opioid use disorder (OUD).

Methods: This is a secondary analysis of a clinical trial of long-acting injectable naltrexone (LAI-naltrexone) among youth with OUD aged 15 to 21 years. Participants were recruited from residential treatment and placed into 1 of 3 treatment groups based on medication receipt at time of discharge (no medication, sublingual buprenorphine-naloxone [buprenorphine], or LAI-naltrexone).

Maternal Perception of Infant Sleep and Bonding in Opioid Use Disorder.

Objective: Infant sleep problems are common in early infancy and can negatively influence maternal-infant bonding. As opioid-exposed neonates are at increased risk of sleep difficulties, we examined the association between maternal perception of infant sleep difficulties and maternal-infant bonding among dyads affected by maternal opioid use disorder (OUD), from birth through 6 months.

Methods: We enrolled 100 birthing people (participants) between 6 months and 2 years postpartum who had received medications for OUD during their pregnancy.