Medications for OUD in the First Trimester and Congenital Malformation Risk

In this large, retrospective cohort study of births covered by Medicaid from 2000-2018, the authors used linked Medicaid use data to compare 9,514 pregnancies with buprenorphine exposure and 3,846 with methadone exposure in the first trimester. After adjusting for relevant confounders, the risk of major congenital malformation was lower for buprenorphine-exposed infants compared to methadone-exposed infants (risk ratio, 0.82; 95% confidence interval, 0.69-0.97), although rates overall remained low (50.9 per 1,000 for buprenorphine and 60.6 per 1,000 for methadone).