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In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants are also discussed. Outside of pregnancy, buprenorphine is used in combination with naloxone to reduce opioid abuse and diversion. During pregnancy, however, the use of buprenorphine as a single agent is preferred to prevent prenatal naloxone exposure. Both methadone and buprenorphine are widely used to treat opioid use disorder; however, compared with methadone, buprenorphine is associated with shorter treatment duration, less medication needed to treat neonatal abstinence syndrome (\n                    <jats:styled-content style=\"fixed-case\">NAS<\/jats:styled-content>\n                    ) symptoms, and shorter hospitalizations for neonates. Despite being the standard of care, medication\u2010assisted treatment with methadone or buprenorphine is still underused, making it apparent that more options are necessary. Naltrexone is not a first\u2010line treatment primarily because both detoxification and an opioid\u2010free period are required. More research is needed to determine naltrexone safety and benefits in pregnant women. Animal studies suggest that changes in pain sensitivity, developmental processes, and behavioral responses may occur in children born to mothers receiving methadone, buprenorphine, or naltrexone and is an area that warrants future studies.\n                  <\/jats:p>","DOI":"10.1002\/phar.1958","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T12:59:31Z","timestamp":1495717171000},"page":"824-839","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women"],"prefix":"10.1002","volume":"37","author":[{"given":"Tran H.","family":"Tran","sequence":"first","affiliation":[{"name":"Pharmacy Practice Midwestern University Chicago College of Pharmacy Downers Grove Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke L.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Pharmacy Practice Midwestern University Chicago College of Pharmacy Downers Grove Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca H.","family":"Stone","sequence":"additional","affiliation":[{"name":"Pharmacy Practice University of Georgia College of Pharmacy Athens Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Vest","sequence":"additional","affiliation":[{"name":"Pharmacy Practice Midwestern University Chicago College of Pharmacy Downers Grove Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Todd","sequence":"additional","affiliation":[{"name":"Pharmacy Practice Midwestern University Chicago College of Pharmacy Downers Grove Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,2]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Prescription painkiller overdoses: a growing epidemic, especially among women","author":"Centers for Disease Control and Prevention","year":"2013"},{"key":"e_1_2_9_3_1","unstructured":"The opioid crisis among the privately insured: the opioid abuse epidemic as documented in private claims data. 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