{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:53:22Z","timestamp":1788915202222,"version":"build-2803163510"},"reference-count":53,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,9,10]]},"abstract":"Importance<\/jats:title>Buprenorphine combined with naloxone is commonly used to treat opioid use disorders outside of pregnancy. In pregnancy, buprenorphine alone is generally recommended because of limited perinatal safety data on the combination product.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare perinatal outcomes following prenatal exposure to buprenorphine with naloxone vs buprenorphine alone.<\/jats:p><\/jats:sec>Design, Settings, and Participants<\/jats:title>Population-based cohort study using health care utilization data from Medicaid-insured beneficiaries in the US from 2000 to 2018. The cohort was restricted to pregnant individuals linked to their liveborn infants, with maternal Medicaid enrollment from 3 months before pregnancy to 1 month after delivery and infant enrollment for the first 3 months after birth, unless they died sooner.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Use of buprenorphine with naloxone vs buprenorphine alone during the first trimester based on outpatient dispensings.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Outcomes included major congenital malformations, low birth weight, neonatal abstinence syndrome, neonatal intensive care unit admission, preterm birth, respiratory symptoms, small for gestational age, cesarean delivery, and maternal morbidity. Confounder-adjusted risk ratios were calculated using propensity score overlap weights.<\/jats:p><\/jats:sec>Results<\/jats:title>This study identified 3369 pregnant individuals exposed to buprenorphine with naloxone during the first trimester (mean [SD] age, 28.8 [4.6] years) and 5326 exposed to buprenorphine alone or who switched from the combination to buprenorphine alone by the end of the first trimester (mean [SD] age, 28.3 [4.5] years). When comparing buprenorphine combined with naloxone with buprenorphine alone, a lower risk for neonatal abstinence syndrome (absolute risk, 37.4% vs 55.8%; weighted relative risk, 0.77 [95% CI, 0.70-0.84]) and a modestly lower risk for neonatal intensive care unit admission (absolute risk, 30.6% vs 34.9%; weighted relative risk, 0.91 [95% CI, 0.85-0.98]) and small for gestational age (absolute risk, 10.0% vs 12.4%; weighted relative risk, 0.86 [95% CI, 0.75-0.98]) was observed. For maternal morbidity, the comparative rates were 2.6% vs 2.9%, respectively, and the weighted relative risk was 0.90 (95% CI, 0.68-1.19). No differences were observed with respect to major congenital malformations overall, low birth weight, preterm birth, respiratory symptoms, or cesarean delivery. Results were consistent across sensitivity analyses.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>There were similar and, in some instances, more favorable neonatal and maternal outcomes for pregnancies exposed to buprenorphine combined with naloxone compared with buprenorphine alone. For the outcomes assessed, compared with buprenorphine alone, buprenorphine with naloxone during pregnancy appears to be a safe treatment option. This supports the view that both formulations are reasonable options for the treatment of opioid use disorder in pregnancy, affirming flexibility in collaborative treatment decision-making.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jama.2024.11501","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T15:01:00Z","timestamp":1723474860000},"page":"805","source":"Crossref","is-referenced-by-count":20,"title":["Comparative Safety of In Utero Exposure to Buprenorphine Combined With Naloxone vs Buprenorphine Alone"],"prefix":"10.1001","volume":"332","author":[{"given":"Loreen","family":"Straub","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Bateman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Hern\u00e1ndez-D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Suarez","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey"},{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seanna M.","family":"Vine","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendr\u00e9e E.","family":"Jones","sequence":"additional","affiliation":[{"name":"UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary S.","family":"Connery","sequence":"additional","affiliation":[{"name":"Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tufts Medical Center and Tufts Clinical and Translational Science Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn J.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Lester","sequence":"additional","affiliation":[{"name":"Center for the Study of Children at Risk, Departments of Psychiatry and Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"},{"name":"Women & Infants Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mishka","family":"Terplan","sequence":"additional","affiliation":[{"name":"Friends Research Institute, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Zakoul","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Mogun","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista F.","family":"Huybrechts","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"joi240081r1","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1001\/jama.2020.24991","article-title":"Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010-2017.","volume":"325","author":"Hirai","year":"2021","journal-title":"JAMA"},{"issue":"6","key":"joi240081r2","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1097\/ALN.0000000000000472","article-title":"Opioid abuse and dependence during pregnancy: temporal trends and obstetrical outcomes.","volume":"121","author":"Maeda","year":"2014","journal-title":"Anesthesiology"},{"issue":"31","key":"joi240081r3","doi-asserted-by":"publisher","first-page":"845","DOI":"10.15585\/mmwr.mm6731a1","article-title":"Opioid use disorder documented at delivery hospitalization\u2014United States, 1999-2014.","volume":"67","author":"Haight","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5-6","key":"joi240081r6","first-page":"347","article-title":"Methadone maintenance treatment (MMT): a review of historical and clinical issues.","volume":"67","author":"Joseph","year":"2000","journal-title":"Mt Sinai J Med"},{"issue":"12","key":"joi240081r7","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1111\/add.v111.12","article-title":"Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta-analysis of safety in the mother, fetus and child.","volume":"111","author":"Zedler","year":"2016","journal-title":"Addiction"},{"issue":"4","key":"joi240081r8","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1097\/AOG.0000000000002861","article-title":"Trends and outcomes associated with using long-acting opioids during delivery hospitalizations.","volume":"132","author":"Duffy","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"22","key":"joi240081r9","doi-asserted-by":"publisher","first-page":"2033","DOI":"10.1056\/NEJMoa2203318","article-title":"Buprenorphine versus methadone for opioid use disorder in pregnancy.","volume":"387","author":"Suarez","year":"2022","journal-title":"N Engl J Med"},{"issue":"24","key":"joi240081r10","doi-asserted-by":"publisher","first-page":"2320","DOI":"10.1056\/NEJMoa1005359","article-title":"Neonatal abstinence syndrome after methadone or buprenorphine exposure.","volume":"363","author":"Jones","year":"2010","journal-title":"N Engl J Med"},{"issue":"3","key":"joi240081r11","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1007\/s002130000637","article-title":"Effects of buprenorphine\/naloxone in opioid-dependent humans.","volume":"154","author":"Stoller","year":"2001","journal-title":"Psychopharmacology (Berl)"},{"issue":"1","key":"joi240081r12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s002130050804","article-title":"Buprenorphine and naloxone combinations: the effects of three dose ratios in morphine-stabilized, opiate-dependent volunteers.","volume":"141","author":"Mendelson","year":"1999","journal-title":"Psychopharmacology (Berl)"},{"issue":"5","key":"joi240081r13","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1097\/ADM.0000000000000045","article-title":"A review of buprenorphine diversion and misuse: the current evidence base and experiences from around the world.","volume":"8","author":"Lofwall","year":"2014","journal-title":"J Addict Med"},{"issue":"3","key":"joi240081r14","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1177\/0269881118756015","article-title":"Buprenorphine alone or with naloxone: which is safer?","volume":"32","author":"Kelty","year":"2018","journal-title":"J Psychopharmacol"},{"key":"joi240081r15","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.549272","article-title":"Reconsidering the usefulness of adding naloxone to buprenorphine.","volume":"11","author":"Blazes","year":"2020","journal-title":"Front Psychiatry"},{"issue":"3","key":"joi240081r16","doi-asserted-by":"publisher","first-page":"374.e1","DOI":"10.1016\/j.ajog.2016.03.015","article-title":"Detoxification from opiate drugs during pregnancy.","volume":"215","author":"Bell","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"joi240081r17","doi-asserted-by":"publisher","first-page":"e385","DOI":"10.1055\/s-0036-1593993","article-title":"Naloxone and metabolites quantification in cord blood of prenatally exposed newborns and correlations with maternal concentrations.","volume":"6","author":"Wiegand","year":"2016","journal-title":"AJP Rep"},{"issue":"1","key":"joi240081r18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/AOG.0000000000002054","article-title":"Opioid use in pregnancy, neonatal abstinence syndrome, and childhood outcomes: executive summary of a joint workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, Society for Maternal-Fetal Medicine, Centers for Disease Control and Prevention, and the March of Dimes Foundation.","volume":"130","author":"Reddy","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"3","key":"joi240081r19","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/ADM.0000000000000562","article-title":"Buprenorphine and naloxone versus buprenorphine for opioid use disorder in pregnancy: a cohort study.","volume":"14","author":"Mullins","year":"2020","journal-title":"J Addict Med"},{"issue":"5","key":"joi240081r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100369","article-title":"Buprenorphine-naloxone use in pregnancy: a subgroup analysis of medication to treat opioid use disorder.","volume":"3","author":"Link","year":"2021","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"6","key":"joi240081r21","doi-asserted-by":"publisher","first-page":"e399","DOI":"10.1097\/ADM.0000000000001004","article-title":"Buprenorphine-naloxone versus buprenorphine for treatment of opioid use disorder in pregnancy.","volume":"16","author":"Perry","year":"2022","journal-title":"J Addict Med"},{"issue":"7","key":"joi240081r22","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1111\/add.v113.7","article-title":"Neonatal outcomes after fetal exposure to methadone and buprenorphine: national registry studies from the Czech Republic and Norway.","volume":"113","author":"Nechansk\u00e1","year":"2018","journal-title":"Addiction"},{"key":"joi240081r23","doi-asserted-by":"publisher","first-page":"61","DOI":"10.4137\/SART.S10955","article-title":"A comparison of buprenorphine + naloxone to buprenorphine and methadone in the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes.","volume":"7","author":"Lund","year":"2013","journal-title":"Subst Abuse"},{"issue":"6","key":"joi240081r26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0067405","article-title":"Harnessing the Medicaid Analytic eXtract (MAX) to evaluate medications in pregnancy: design considerations.","volume":"8","author":"Palmsten","year":"2013","journal-title":"PLoS One"},{"issue":"1","key":"joi240081r27","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1002\/pds.v22.1","article-title":"Algorithms to estimate the beginning of pregnancy in administrative databases.","volume":"22","author":"Margulis","year":"2013","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"1","key":"joi240081r28","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/EDE.0000000000001559","article-title":"Development and validation of algorithms to estimate live birth gestational age in Medicaid Analytic eXtract data.","volume":"34","author":"Zhu","year":"2023","journal-title":"Epidemiology"},{"issue":"5","key":"joi240081r29","doi-asserted-by":"publisher","first-page":"e1502","DOI":"10.1542\/peds.2012-3435","article-title":"Temporal trends in survival among infants with critical congenital heart defects.","volume":"131","author":"Oster","year":"2013","journal-title":"Pediatrics"},{"issue":"4","key":"joi240081r30","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1002\/pds.v29.4","article-title":"Validation of algorithms to identify adverse perinatal outcomes in the Medicaid Analytic Extract database.","volume":"29","author":"He","year":"2020","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"6","key":"joi240081r31","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1002\/pds.v23.6","article-title":"Validity of maternal and infant outcomes within nationwide Medicaid data.","volume":"23","author":"Palmsten","year":"2014","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"102","key":"joi240081r32","doi-asserted-by":"publisher","first-page":"n102","DOI":"10.1136\/bmj.n102","article-title":"Association of first trimester prescription opioid use with congenital malformations in the offspring: population based cohort study.","volume":"372","author":"Bateman","year":"2021","journal-title":"BMJ"},{"key":"joi240081r33","doi-asserted-by":"publisher","first-page":"j3326","DOI":"10.1136\/bmj.j3326","article-title":"Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study.","volume":"358","author":"Huybrechts","year":"2017","journal-title":"BMJ"},{"issue":"5","key":"joi240081r34","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1097\/AOG.0b013e3182a603bb","article-title":"Development of a comorbidity index for use in obstetric patients.","volume":"122","author":"Bateman","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"4","key":"joi240081r35","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s10995-007-0256-6","article-title":"An enhanced method for identifying obstetric deliveries: implications for estimating maternal morbidity.","volume":"12","author":"Kuklina","year":"2008","journal-title":"Matern Child Health J"},{"issue":"2","key":"joi240081r36","doi-asserted-by":"publisher","first-page":"133.e1","DOI":"10.1016\/j.ajog.2007.12.020","article-title":"Identification of severe maternal morbidity during delivery hospitalizations, United States, 1991-2003.","volume":"199","author":"Callaghan","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"joi240081r37","doi-asserted-by":"publisher","first-page":"h2102","DOI":"10.1136\/bmj.h2102","article-title":"Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study.","volume":"350","author":"Desai","year":"2015","journal-title":"BMJ"},{"issue":"8","key":"joi240081r38","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.28588","article-title":"Characteristics of prescription opioid analgesics in pregnancy and risk of neonatal opioid withdrawal syndrome in newborns.","volume":"5","author":"Esposito","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"9","key":"joi240081r39","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.2105\/AJPH.84.9.1414","article-title":"An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index.","volume":"84","author":"Kotelchuck","year":"1994","journal-title":"Am J Public Health"},{"issue":"25","key":"joi240081r42","doi-asserted-by":"publisher","first-page":"3083","DOI":"10.1002\/sim.v28:25","article-title":"Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples.","volume":"28","author":"Austin","year":"2009","journal-title":"Stat Med"},{"issue":"6","key":"joi240081r43","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1111\/joim.2014.275.issue-6","article-title":"Propensity scores for confounder adjustment when assessing the effects of medical interventions using nonexperimental study designs.","volume":"275","author":"St\u00fcrmer","year":"2014","journal-title":"J Intern Med"},{"issue":"1","key":"joi240081r44","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1093\/aje\/kwy201","article-title":"Addressing extreme propensity scores via the overlap weights.","volume":"188","author":"Li","year":"2019","journal-title":"Am J Epidemiol"},{"issue":"10","key":"joi240081r45","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1002\/pds.v32.10","article-title":"Differences in target estimands between different propensity score-based weights.","volume":"32","author":"Austin","year":"2023","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"4","key":"joi240081r46","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1097\/EDE.0b013e3181a663cc","article-title":"High-dimensional propensity score adjustment in studies of treatment effects using health care claims data.","volume":"20","author":"Schneeweiss","year":"2009","journal-title":"Epidemiology"},{"issue":"25","key":"joi240081r47","doi-asserted-by":"publisher","first-page":"2397","DOI":"10.1056\/NEJMoa1312828","article-title":"Antidepressant use in pregnancy and the risk of cardiac defects.","volume":"370","author":"Huybrechts","year":"2014","journal-title":"N Engl J Med"},{"issue":"9","key":"joi240081r48","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1001\/jamapsychiatry.2016.1520","article-title":"Antipsychotic use in pregnancy and the risk for congenital malformations.","volume":"73","author":"Huybrechts","year":"2016","journal-title":"JAMA Psychiatry"},{"issue":"23","key":"joi240081r49","doi-asserted-by":"publisher","first-page":"2429","DOI":"10.1001\/jama.2018.18307","article-title":"Association of maternal first-trimester ondansetron use with cardiac malformations and oral clefts in offspring.","volume":"320","author":"Huybrechts","year":"2018","journal-title":"JAMA"},{"issue":"4","key":"joi240081r50","doi-asserted-by":"publisher","first-page":"268","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-value.","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Intern Med"},{"issue":"1","key":"joi240081r51","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00001648-199001000-00010","article-title":"No adjustments are needed for multiple comparisons.","volume":"1","author":"Rothman","year":"1990","journal-title":"Epidemiology"},{"issue":"2","key":"joi240081r52","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/00031305.2016.1154108","article-title":"The ASA statement on P values: context, process, and purpose.","volume":"70","author":"Wasserstein","year":"2016","journal-title":"Am Stat"},{"issue":"10","key":"joi240081r53","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0240298","article-title":"Private health insurance coverage of drug use disorder treatment: 2005-2018.","volume":"15","author":"Mojtabai","year":"2020","journal-title":"PLoS One"},{"key":"joi240081r4","unstructured":"Mascola? M, Borders? A, Terplan? M. Opioid use and opioid use disorder in pregnancy (ACOG Committee Opinion, Number 711). Accessed July 31, 2023. https:\/\/www.acog.org\/-\/media\/project\/acog\/acogorg\/clinical\/files\/committee-opinion\/articles\/2017\/08\/opioid-use-and-opioid-use-disorder-in-pregnancy.pdf"},{"key":"joi240081r5","unstructured":"World Health Organization. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. Accessed July 31, 2023. https:\/\/www.who.int\/publications\/i\/item\/9789241548731"},{"key":"joi240081r24","unstructured":"MACPAC. Report to the Congress on Medicaid and CHIP, Chapter 3: issues in pregnancy coverage under Medicaid and Exchange plans. March 2014:39-60. Accessed March 5, 2020. https:\/\/www.macpac.gov\/publication\/report-to-the-congress-on-medicaid-and-chip-314\/"},{"key":"joi240081r25","unstructured":"Substance Abuse and Mental Health Services Administration. Medicaid coverage of medication-assisted treatment for alcohol and opioid use disorders and of medication for the reversal of opioid overdose. 2018. Accessed June 13, 2024. https:\/\/store.samhsa.gov\/sites\/default\/files\/medicaidfinancingmatreport_0.pdf"},{"key":"joi240081r40","unstructured":"US Department of Agriculture\u2014Economic Research Service. Download data for county-level data sets. Accessed March 18, 2020. https:\/\/www.ers.usda.gov\/data-products\/county-level-data-sets\/download-data\/"},{"key":"joi240081r41","unstructured":"US Department of Housing and Urban Development\u2019s Office of Policy Development and Research. HUD-USPS ZIP crosswalk files. Accessed March 18, 2020. https:\/\/www.huduser.gov\/portal\/datasets\/usps_crosswalk.html#data"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2822178\/jama_straub_2024_oi_240081_1725043013.62424.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T15:04:25Z","timestamp":1725980665000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2822178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":53,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,9,10]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2024.11501","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9,10]]}}}