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Pregnant patients receiving medication to treat opioid use disorder should not reduce their medication dose out of fear that it will worsen withdrawal symptoms in their newborns, according to a new study led by researchers at the University of Maryland School of Medicine (UMSOM).

The findings suggest that lowering medication doses during pregnancy is not an effective strategy for preventing severe neonatal opioid withdrawal syndrome (NOWS) and reinforce the importance of maintaining treatment to protect mothers from relapse and overdose.

The research letter, published in the journal JAMA Network Open, examined whether doses of methadone and buprenorphine—the two medications commonly used to treat opioid use disorder during pregnancy—were associated with the severity of the withdrawal syndrome in newborns.

The researchers found that the levels of these medications measured in umbilical cord tissue after childbirth were not associated with the severity of this syndrome.

Opioid use disorder is a leading cause of death associated with pregnancy and the postpartum period, according to the American Medical Association. Mortality rates rose more than 80% between 2017 and 2020. Medication for opioid use disorder (MOUD) is an evidence-based treatment that helps stabilize the condition and reduce the risk of relapse and overdose, and has been shown to be safe in general to use during pregnancy.

However, concerns that higher medication doses may cause more severe withdrawal in newborns can lead some patients and clinicians to consider lowering doses or stopping treatment during pregnancy.

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