Prenatal exposure to methadone or buprenorphine: Early childhood developmental outcomes

Drug Alcohol Depend. 2018 Apr 1;185:40-49. doi: 10.1016/j.drugalcdep.2017.11.030. Epub 2018 Feb 1.


Background: Methadone and buprenorphine are recommended to treat opioid use disorders during pregnancy. However, the literature on the relationship between longer-term effects of prenatal exposure to these medications and childhood development is both spare and inconsistent.

Methods: Participants were 96 children and their mothers who participated in MOTHER, a randomized controlled trial of opioid-agonist pharmacotherapy during pregnancy. The present study examined child growth parameters, cognition, language abilities, sensory processing, and temperament from 0 to 36 months of the child's life. Maternal perceptions of parenting stress, home environment, and addiction severity were also examined.

Results: Tests of mean differences between children prenatally exposed to methadone vs. buprenorphine over the three-year period yielded 2/37 significant findings for children. Similarly, tests of mean differences between children treated for NAS relative to those not treated for NAS yielded 1/37 significant finding. Changes over time occurred for 27/37 child outcomes including expected child increases in weight, head and height, and overall gains in cognitive development, language abilities, sensory processing, and temperament. For mothers, significant changes over time in parenting stress (9/17 scales) suggested increasing difficulties with their children, notably seen in increasing parenting stress, but also an increasingly enriched home environment (4/7 scales) CONCLUSIONS: Findings strongly suggest no deleterious effects of buprenorphine relative to methadone or of treatment for NAS severity relative to not-treated for NAS on growth, cognitive development, language abilities, sensory processing, and temperament. Moreover, findings suggest that prenatal opioid agonist exposure is not deleterious to normal physical and mental development.

Keywords: Early childhood development; Neonatal abstinence syndrome (NAS); Opioid agonist medication; Prenatal exposure.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Buprenorphine / adverse effects*
  • Buprenorphine / therapeutic use
  • Child Development / drug effects*
  • Child, Preschool
  • Cognition / drug effects
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Methadone / adverse effects*
  • Methadone / therapeutic use
  • Mothers
  • Neonatal Abstinence Syndrome / diagnosis*
  • Neonatal Abstinence Syndrome / psychology
  • Opioid-Related Disorders / drug therapy*
  • Parenting
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Prenatal Exposure Delayed Effects / diagnosis*
  • Prenatal Exposure Delayed Effects / psychology
  • Temperament / drug effects


  • Buprenorphine
  • Methadone