OBJECTIVES: About 5.4% of women are diagnosed with Opioid Use Disorder (OUD). Medication Assisted Treatments (MATs) are used to treat OUD with Buprenorphine and/or Methadone. Our objective is to compare maternal and neonatal outcomes in women with OUD, treated with Buprenorphine or Methadone based MATs during pregnancy.

METHODS: The study is a retrospective cohort analysis, conducted using 10% sample of IMS Health Incorporated’s PharMetrics Plus^TM, claims database covering January 2007 to December 2015. It is a fully adjudicated closed medical and pharmacy claims database from health plans and self-employed groups with a mix of commercial PPO, commercial Medicare and Medicaid data, representing over 12 million unique patients. Inclusion criteria 1) female aged 15 to 44 years, 2) incidence of childbirth as a marker of pregnancy and 3) diagnosis of opioid use disorder through International Classification of Disease 9 Clinical Modifications (ICD – 9 CM) diagnostic codes. Claims for subsequent pregnancies other than first pregnancy are excluded. The analytic cohort has (N=616) first pregnancy claims with OUD that receive Buprenorphine (Subutex), Methadone or Buprenorphine+Methadone (Subuxone) based MATs. A comparison between Buprenorphine and Methadone based MATs is done using chi square statistics on maternal and neonatal outcomes.

RESULTS: The incidence of live births is (0.9%) higher and the incidence of stillbirth is (1.6%) lower among women receiving Buprenorphine (vs Methadone) based MAT (P>0.05). The incidences of Neonatal Abstinence Syndrome (NAS) and Neonatal intensive care unit (NICU) admission are, (10.7 %) and (8.2 %) respectively, lower among women treated with Buprenorphine based MAT compared to Methadone based MAT (P<0.05).

CONCLUSIONS: Neonatal outcomes in infants of women who have OUD and are treated with Buprenorphine, are more favorable than neonatal outcomes in their counterparts who are treated with Methadone. Further studies should investigate system specific factors that can stimulate favorable neonatal outcomes in pregnant women with OUD.