Umbilical Cord Methadone and Buprenorphine Levels and Neonatal Opioid Withdrawal Severity
JAMA Network Open 10.1001/jamanetworkopen.2026.41876October 29, 2026 at 11:00 AM EDT
This cohort study evaluates associations of methadone and buprenorphine levels in umbilical cord tissue with medication for opioid use disorder dosage and neonatal opioid withdrawal syndrome severity.
This secondary analysis of a multisite cohort of pregnant individuals with opioid use disorder enrolled from 2016 to 2025 found that methadone-exposed neonates were more likely than buprenorphine-exposed neonates to experience severe neonatal opioid withdrawal syndrome (NOWS). However, neither maternal medication dose nor umbilical cord levels of methadone, buprenorphine, or their metabolites were associated with NOWS severity, suggesting that dose reduction during pregnancy may not prevent severe NOWS.
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