Jamie Lo, MD, MCR, highlights maternal and infant risks from prenatal opioid use

In an interview with Contemporary OB/GYN, Jamie Lo, MD, MCR, associate professor at Oregon Health & Science University, discussed findings from a large cohort study examining how prenatal opioid use affects both maternal and infant health, expanding on prior research that has often focused primarily on neonatal outcomes.^1,2

Opioid use during pregnancy has long been associated with adverse effects for pregnant individuals and their infants, but this study sought to more comprehensively evaluate opioid-related diagnoses and outcomes using a substantially larger population than earlier analyses. The results showed significantly increased risks for both mothers and babies. Among pregnant individuals with opioid-related diagnoses, maternal complications included higher rates of hypertensive disorders, increased need for blood transfusions, and overall greater morbidity.

Infant outcomes were also notably worse, with elevated risks of infant death, preterm birth, neonatal intensive care unit (NICU) admission, respiratory distress syndrome, and neonatal abstinence syndrome. One of the most concerning findings was a more than 2-fold increase in the prevalence of opioid use during pregnancy over the past decade, despite growing awareness of opioid use disorder and its complications. According to Lo, this trend underscores persistent gaps in access to care, public awareness, and institutional commitment to comprehensive, multidisciplinary treatment models.

Lo emphasized that, unlike many other substance use disorders in pregnancy, opioid use disorder has evidence-based treatments that can meaningfully reduce adverse outcomes. Medication-assisted treatment with methadone or buprenorphine—particularly buprenorphine, which has been associated with improved fetal growth, lower rates of preterm birth, and reduced severity of neonatal withdrawal—plays a central role. The study’s findings highlight the importance of addressing maternal and infant needs together, spanning prenatal, intrapartum, and postnatal care.

From a clinical practice standpoint, the data reinforce the need to shift beyond a neonatal-only focus and adopt a family-centered approach. This includes improving access to medication-assisted treatment, integrating mental health services, and providing breastfeeding support after delivery. For infants exposed to opioids in utero, nonpharmacologic strategies such as the “Eat, Sleep, Console” model, which emphasizes parental involvement and supportive care, may help reduce the severity of neonatal abstinence syndrome.

Lo also highlighted the growing relevance of polysubstance use during pregnancy, noting that opioids are often used alongside other substances. While the combined effects are not yet fully understood, ongoing research may identify opportunities to modify care and improve outcomes. Overall, the study underscores the urgent need for coordinated, accessible, and sustained support for pregnant individuals with opioid use disorder and their families.

No relevant disclosures.

References

1. Rates of opioid use in pregnancy have more than doubled, study finds. Oregon Health & Science University. December 23, 2025. Accessed January 5, 2026. https://www.eurekalert.org/news-releases/1111017
2. Prewitt K, Ryan KS, Garg B, et al. Maternal opioid-related diagnosis in pregnancy and risk of adverse perinatal outcomes. Journal of Addiction Medicine. 2025. doi:10.1097/ADM.0000000000001638