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In both studies, participants received voucher\u2010based incentives for attendance and completion of study assessments. In the MOTHER trial, participants additionally received escalating voucher incentives for drug\u2010free urine samples. Neonatal abstinence syndrome was treated with oral morphine solution based on standardized modified Finnegan scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After a mean treatment period of 13.79\u2009weeks in the Pilot study (PS,<jats:italic>n<\/jats:italic>\u2009=\u200918) and 20.78\u2009weeks in the MOTHER\u2010trial (MT,<jats:italic>n<\/jats:italic>\u2009=\u200941), respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), PS patients delivered at mean doses of 14.00\u2009mg buprenorphine\/52.50\u2009mg methadone and MT participants at 13.44\u2009mg buprenorphine\/63.68\u2009mg methadone. Nonsignificant differences regarding dropout rates were found (22% in PS versus 10% in MT), but dropout was significantly earlier in the MT (<jats:italic>p<\/jats:italic>\u2009=\u20090.013). Significantly higher rates of concomitant consumption of opioids and benzodiazepines occurred in the PS compared with the MT (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), however, with no significant differences in neonatal data between both settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early treatment enrolment combined with contingency management contributes to reduced illicit drug use throughout pregnancy, surprisingly without influencing neonatal outcome parameters. 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