Buprenorphine and methadone are both first-line treatments for opioid use disorder during pregnancy. Though this recommendation has been long-standing, it is based on a rather small study that is nearly 15 years old. In the current study, researchers revisit the question of how best to treat opioid use disorder during pregnancy with a large observational cohort study.

Dr. Johnson tells us all about Child Protective Services and how they work with pregnant patients who use substances. In this interview, she reviews the role of medical and mental health providers in the care of pregnant patients with addictive disorders and their legal obligations. She also provides tips for discussing these sensitive matters with your patients.

The last high-quality head-to-head comparison of buprenorphine and methadone during pregnancy was the MOTHER trial, which was published nearly 15 years ago. Here, researchers revisited the question of which medication is better to use in pregnancy in this large, carefully done, retrospective study. The results make a compelling case for buprenorphine. 

As the overall prevalence of opioid use disorder has increased, so to has the prevalence of opioid use during pregnancy. Opioid use during pregnancy can put both your patient and the baby at risk, making proper treatment with MOUD essential. In this article, we outline the special considerations for the treatment of OUD during pregnancy and discuss how to prescribe MOUD safely. 

Peripartum mood problems are common, particularly for women with bipolar disorder. 

Pregnant patients with OUD may be reluctant to reveal their substance use for fear of losing their baby if reported to Child Protective Services. But this recent study shows that pregnant patients receiving medication treatment for OUD were more likely to leave the hospital with their baby than patients not receiving treatment.

This large study gives us reassuring data about neurodevelopmental outcomes in children exposed to several second-generation antipsychotic medications during pregnancy.

Postpartum depression is surprisingly common, yet often missed. We discuss screening techniques to ensure you won’t miss it, and share treatment approaches, including novel strategies like brexanolone, zuranolone, and TMS.

You might worry about prescribing antidepressants during pregnancy, but data on their safety is increasingly reassuring. We provide an in-depth review on how to treat depression in pregnancy and breastfeeding.