What the study found
The study found no increased long-term risk of adverse neurodevelopmental outcomes among children with prenatal exposure to buprenorphine compared with methadone.
Why the authors say this matters
The authors conclude that these findings further support buprenorphine as a safe treatment option for opioid use disorder during pregnancy. The study suggests that prenatal buprenorphine exposure does not raise long-term neurodevelopmental risk relative to methadone.
What the researchers tested
This was a population-based cohort study using US nationwide Medicaid data on more than 2.5 million live births from 2000 to 2018. The researchers compared children prenatally exposed to buprenorphine versus methadone and examined a composite outcome of neurodevelopmental disorders, including autism spectrum disorder, attention deficit/hyperactivity disorder, developmental speech or language disorder, developmental coordination disorder, behavioural disorder, learning difficulty, and intellectual disability.
What worked and what didn't
Among 12,635 children exposed to buprenorphine and 5,390 exposed to methadone, the crude cumulative incidence of any neurodevelopmental disorder at age 8 years was 34% for buprenorphine and 33% for methadone. Adjusted analyses suggested slightly lower hazards with buprenorphine overall, and similar results were reported for individual disorders such as attention deficit/hyperactivity disorder and autism spectrum disorder. However, this lower hazard was not seen when treatment was initiated during pregnancy, and sensitivity analyses were consistent with no increased risk for buprenorphine versus methadone.
What to keep in mind
The abstract does not describe detailed study limitations beyond the observed differences between prevalent use and treatment initiation during pregnancy. The results apply to this Medicaid-based cohort and to the exposures and outcomes measured in the study.
Key points
- Prenatal buprenorphine exposure was not linked to a higher long-term risk of neurodevelopmental disorders than methadone exposure.
- The study used US nationwide Medicaid data covering more than 2.5 million live births from 2000 to 2018.
- The main outcome was a composite of neurodevelopmental disorders, including autism spectrum disorder and attention deficit/hyperactivity disorder.
- Adjusted analyses suggested slightly lower hazards with buprenorphine overall, with an adjusted hazard ratio of 0.81.
- The lower hazard was not observed when treatment was initiated during pregnancy.
Disclosure
- Research title:
- Buprenorphine linked to no higher neurodevelopmental risk than methadone
- Authors:
- Sabine Friedrich, Krista F Huybrechts, Loreen Straub, Sonia Hernandez-Diaz, Yanmin Zhu, Georg Hahn, Helen Mogun, Hendrée E. Jones, Hilary S Connery, Jonathan M Davis, Kathryn J Gray, Barry Lester, Mishka Terplan, Brian T Bateman
- Institutions:
- Brigham and Women's Hospital, Harvard University, University of North Carolina at Chapel Hill, McLean Hospital, Tufts Medical Center, University of Washington, Women & Infants Hospital of Rhode Island, Friends Research Institute, Stanford University
- Publication date:
- 2026-04-15
- OpenAlex record:
- View
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