Buprenorphine and methadone for opioid addiction during pregnancy

Obstet Gynecol Clin North Am. 2014 Jun;41(2):241-53. doi: 10.1016/j.ogc.2014.02.005. Epub 2014 Apr 3.


Buprenorphine and methadone are opioid-receptor agonists used as opioid substitution therapy during pregnancy to limit exposure of the fetus to cycles of opioid withdrawal and reduce the risk of infectious comorbidities of illicit opioid use. As part of a comprehensive care plan, such therapy may result in improved access to prenatal care, reduced illicit drug use, reduced exposure to infections associated with intravenous drug use, and improved maternal nutrition and infant birth weight. This article describes differences in patient selection between the two drugs, their relative safety during pregnancy, and changes in daily doses as a guide for prescribing clinicians.

Keywords: Abstinence; Buprenorphine; Methadone; Neonatal; Pregnancy opioid addiction.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects*
  • Buprenorphine / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Humans
  • Methadone / therapeutic use*
  • Neonatal Abstinence Syndrome / drug therapy
  • Neonatal Abstinence Syndrome / prevention & control*
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / drug therapy*
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / psychology*
  • Pregnant Women / psychology
  • Prenatal Exposure Delayed Effects
  • Substance-Related Disorders / drug therapy*
  • Substance-Related Disorders / psychology
  • Treatment Outcome


  • Analgesics, Opioid
  • Buprenorphine
  • Methadone