SynthesisSubstance abuse treatment, prevention, and policy2025
Barriers to opioid replacement therapy in pregnant women with opioid use disorder: a systematic review.
Synthesis in Substance abuse treatment, prevention, and policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
2 citing papers in PubMed.
- Opioid use disorder and medication for opioid use disorder among pregnant women with commercial insurance in the United States, 2016-2020.Drug and alcohol dependence · 2026Article
- Experiences of People Who Discontinue Long-Acting Injectable Buprenorphine Treatment Recently Released From Prison in New South Wales, Australia.Drug and alcohol review · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOpioid use disorder (OUD) during pregnancy has increased dramatically, paralleling epidemic trends in the general population. Pregnant women with OUD face considerable risks of adverse outcomes. While medications for opioid use disorder (MOUD) is the mainstay of treatment, substantial barriers limit its implementation. Despite the critical need for effective interventions, a comprehensive synthesis of the challenges to MOUD during pregnancy remains lacking. This review examines these barriers to improve treatment access and outcomes for this vulnerable population.
methodsThis review was conducted in accordance with the PRISMA 2020 guidelines and was registered in PROSPERO (registration number: CRD420251047657). We searched for peer-reviewed articles in PubMed, Scopus, and ScienceDirect published between 2015 and 2025, using a combination of keywords and MeSH terms. Two independent reviewers screened studies, extracted data, and assessed quality using the Joanna Briggs Institute (JBI) critical appraisal tools. Discrepancies were resolved through consensus with a third author. Data were synthesized narratively to identify key challenges in the treatment of OUD during pregnancy.
resultsOf the 9,288 articles identified from databases and websites, 23 met the eligibility criteria, including 14 qualitative studies, 5 cross-sectional studies, and 4 review articles. Patient-related barriers to accessing MOUD for pregnant women with OUD included fear of stigma and child custody loss, concerns about fetal risks, childcare and legal issues, coping with abuse, guilt, social pressure, and financial constraints. Meanwhile, provider-related barriers involved knowledge gaps, inadequate training, bias, stigma, time constraints, and the perceived complexity of treating OUD during pregnancy. Moreover, system-level barriers such as fragmented care models, geographic disparities, gaps in insurance coverage, and punitive policies further limited access to treatment.
conclusionPregnant women with OUD face barriers including stigma, childcare demands, provider bias, training gaps, fragmented care, financial and insurance issues, and punitive policies. Implementing patient-centered care, provider education, policy reforms, and practical supports may help promote compassionate, equitable treatment for this vulnerable population.
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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.