ArticlePaediatric and perinatal epidemiology2018
The Role of Preterm Birth in the Association Between Opioid Maintenance Therapy and Neonatal Abstinence Syndrome.
Article in Paediatric and perinatal epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- The comparative effects of prenatal exposure to methadone versus buprenorphine for opioid use disorder on neonatal outcomes: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2026Pooled it
- Non-pharmacological care for opioid withdrawal in newborns.The Cochrane database of systematic reviews · 2020Pooled it
- Maternal exposure to buprenorphine, but not methadone, during pregnancy reduces social play behavior across two generations of offspring.Psychopharmacology · 2025Article
- Opioid analgesic and antidepressant use during pregnancy and the risk of spontaneous preterm birth: A nested case-control study.Paediatric and perinatal epidemiology · 2025Article
- Assessing the Eat, Sleep, Console model for neonatal abstinence syndrome management at a regional referral center.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Hypoglycaemia in non-diabetic pregnancy.Obstetric medicine · 2023Article
- Delivery timing for the opioid-exposed infant.American journal of obstetrics & gynecology MFM · 2022Article
- Article
- Article
- Integrated Review of the Assessment of Newborns With Neonatal Abstinence Syndrome.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2021Review
- Mediation analysis for estimating cardioprotection of longitudinal RAS inhibition beyond lowering blood pressure and albuminuria in type 1 diabetes.Annals of epidemiology · 2020Article
- Risk Factors Associated with the Occurrence of Neonatal Opioid Withdrawal Syndrome: A Review.CNS drugs · 2019Review
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPregnant women treated with methadone as opioid maintenance therapy are more likely than women treated with buprenorphine to deliver preterm. Preterm birth is associated with less risk of neonatal abstinence syndrome (NAS). We sought to assess the role of preterm birth as a mediator of the relationship between in utero exposure to methadone and NAS compared with buprenorphine.
methodsWe studied 716 women receiving methadone or buprenorphine and delivering liveborn infants at Magee-Womens Hospital, Pittsburgh, Pennsylvania (2013-15). We implemented inverse probability weighted marginal structural models to isolate the role of preterm birth (<37 weeks' gestation). Weights accounted for confounding by maternal age, race, insurance, parity, delivery year, marital, employment, hepatitis C, and smoking status.
resultsApproximately 57% of the cohort were treated with methadone. Preterm birth was more common in methadone-exposed pregnancies (25% versus 14%). The incidence of NAS treatment was higher in methadone compared with buprenorphine-exposed infants (65% vs 49%), and term compared with preterm births (64% vs 36%). For every 100 infants liveborn to mothers treated for opioid dependence, there were 13 excess cases of NAS among infants exposed to methadone compared with buprenorphine (adjusted risk difference [RD] 13.3, 95% confidence interval [CI] 5.7, 20.9). Among term births, this increased to 17 excess cases of NAS in methadone- compared with buprenorphine-exposed (RD 16.7, 95% CI 9.3, 24.0).
conclusionThe further increased risk of NAS associated with methadone use vs buprenorphine in term deliveries emphasises the utility of buprenorphine in clinical settings aimed at decreasing NAS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.