Chronic opioid use during pregnancy: maternal and fetal implications

Clin Perinatol. 2013 Sep;40(3):337-50. doi: 10.1016/j.clp.2013.05.015. Epub 2013 Jul 4.


Current trends in the United States suggest that chronic narcotic use has increased in reproductive aged women over the past 10 years. Regular exposure to such substances during pregnancy has maternal and fetal implications. Appropriate prenatal care is critical to optimizing outcomes. Management options for narcotic dependence should be patient-specific and may include discontinuation of narcotics with careful observation, limitation of prescription dispensing, or substitution therapy with methadone or buprenorphine. A multidisciplinary, collaborative approach is highly recommended. This review discusses usage of narcotic medications, associated maternal and fetal risks, and management strategies for the antepartum, intrapartum, and postpartum periods.

Keywords: Buprenorphine; Methadone; Narcotic; Opioid; Pregnancy.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / adverse effects
  • Buprenorphine / therapeutic use
  • Female
  • Humans
  • Infant, Newborn
  • Methadone / adverse effects
  • Methadone / therapeutic use
  • Neonatal Abstinence Syndrome / therapy*
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / rehabilitation*
  • Pregnancy
  • Pregnancy Complications / rehabilitation*
  • Prenatal Care / methods


  • Analgesics, Opioid
  • Buprenorphine
  • Methadone