Current Research on Opioid Use Disorder (OUD) in Pregnancy with Emphasis on Medication Assisted Treatment (MAT)

Abstract

Substance use disorder in pregnancy is a major obstetric issue, with significant maternal and fetal morbidity and mortality. The incidence of opioid use disorder has risen substantially in the United States, with overdose now a leading contributor to pregnancy related deaths. Medication assisted treatment for opioid use disorder can improve pregnancy outcomes, with Methadone, and more recently Buprenorphine becoming the mainstays of treatment. There is decreased incidence of neonatal abstinence syndrome with maternal Buprenorphine use, as well as possible decreased association with neonatal low birth weight. Despite the known benefits of treatment, there remain barriers to medication assisted treatment, including clinician stigma and lack of familiarity with pharmacology. The American College of Obstetrics and Gynecology maintains a firm stance on the benefits of treatment during pregnancy, in order to avoid the known adverse outcomes associated with substance abuse during pregnancy. Pregnancy is period when most women routinely seek healthcare, and thus allows the opportunity for obstetrical providers to optimize maternal well-being. The goals during pregnancy remain the same as those outside of pregnancy: For medication treatment to assist in the prevention of a chronic and remitting condition that can result in overdose, and provide a gateway towards long-term recovery.