{"title":"Buprenorphine-based treatments outcomes in pregnant opioid-dependent women: A systematic review and meta-analysis.","authors":"Farzad Akbarzadeh, Alireza Ebrahimi","doi":"10.1111/add.70265","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Opioid addiction poses a significant challenge to both the health of mothers and the outcomes for their newborns. Treatments based on buprenorphine offer a proven strategy for addressing opioid dependence among pregnant women. Various studies have examined the effectiveness of buprenorphine treatments versus methadone, revealing several potential advantages of buprenorphine for the outcomes of newborns. This systematic review sought to clarify the benefits and risks associated with buprenorphine therapy.</p><p><strong>Methods: </strong>The PubMed, Web of Science and Scopus databases were searched with keywords for qualifying papers published before February 2025. Mean differences (MD) and 95% confidence intervals (CIs) were calculated for continuous data, while pooled proportions were estimated for categorical variables. Interstudy heterogeneity and publication bias were assessed using I<sup>2</sup> and Egger's tests with Meta-Essential software analyses.</p><p><strong>Results: </strong>The initial database search identified 2019 studies. Following a screening process based on inclusion criteria, 38 studies were selected for data extraction. The number of participants involved in all included studies was 5524. The results indicated that infants exposed to methadone had a higher incidence of neonatal abstinence syndrome (NAS) and required more pharmacologic treatment compared with those exposed to buprenorphine-naloxone (0.44, 95% CI = 0.25-0.75, P < 0.01). Additionally, infants exposed to buprenorphine had slightly higher birth weights than those exposed to methadone (0.17 kg, 95% CI = -0.14 to 1.49, P = 0.049), which might be linked to a greater need for NAS treatment.</p><p><strong>Conclusion: </strong>Compared with methadone in treating opioid use disorder during pregnancy, buprenorphine-based therapies, buprenorphine-naloxone in particular, have demonstrated greater efficacy in enhancing neonatal outcomes.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"1066-1082"},"PeriodicalIF":5.9000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/add.70265","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/12/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
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Abstract
Background and aims: Opioid addiction poses a significant challenge to both the health of mothers and the outcomes for their newborns. Treatments based on buprenorphine offer a proven strategy for addressing opioid dependence among pregnant women. Various studies have examined the effectiveness of buprenorphine treatments versus methadone, revealing several potential advantages of buprenorphine for the outcomes of newborns. This systematic review sought to clarify the benefits and risks associated with buprenorphine therapy.
Methods: The PubMed, Web of Science and Scopus databases were searched with keywords for qualifying papers published before February 2025. Mean differences (MD) and 95% confidence intervals (CIs) were calculated for continuous data, while pooled proportions were estimated for categorical variables. Interstudy heterogeneity and publication bias were assessed using I2 and Egger's tests with Meta-Essential software analyses.
Results: The initial database search identified 2019 studies. Following a screening process based on inclusion criteria, 38 studies were selected for data extraction. The number of participants involved in all included studies was 5524. The results indicated that infants exposed to methadone had a higher incidence of neonatal abstinence syndrome (NAS) and required more pharmacologic treatment compared with those exposed to buprenorphine-naloxone (0.44, 95% CI = 0.25-0.75, P < 0.01). Additionally, infants exposed to buprenorphine had slightly higher birth weights than those exposed to methadone (0.17 kg, 95% CI = -0.14 to 1.49, P = 0.049), which might be linked to a greater need for NAS treatment.
Conclusion: Compared with methadone in treating opioid use disorder during pregnancy, buprenorphine-based therapies, buprenorphine-naloxone in particular, have demonstrated greater efficacy in enhancing neonatal outcomes.
背景和目的：阿片类药物成瘾对母亲的健康及其新生儿的结局构成了重大挑战。基于丁丙诺啡的治疗为解决孕妇阿片类药物依赖提供了一种行之有效的策略。各种研究已经检查了丁丙诺啡与美沙酮治疗的有效性，揭示了丁丙诺啡对新生儿结局的几个潜在优势。本系统综述旨在阐明丁丙诺啡治疗的益处和风险。方法：检索2025年2月前发表的符合条件的论文，检索PubMed、Web of Science和Scopus数据库。对连续数据计算平均差异（MD）和95%置信区间（ci），对分类变量估计合并比例。采用Meta-Essential软件分析的I2和Egger检验评估研究间异质性和发表偏倚。结果：最初的数据库搜索确定了2019项研究。在基于纳入标准的筛选过程中，选择38项研究进行数据提取。所有纳入研究的参与者人数为5524人。结果显示，与丁丙诺啡-纳洛酮组相比，美沙酮组新生儿戒断综合征（NAS）发生率更高，且需要更多的药物治疗（0.44,95% CI = 0.25-0.75， P）。结论：与美沙酮组相比，丁丙诺啡为主的治疗方法，尤其是丁丙诺啡-纳洛酮组在改善妊娠阿片类药物使用障碍方面效果更好。
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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