{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:57:49Z","timestamp":1786543069012,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T00:00:00Z","timestamp":1516924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pregnant women treated with methadone as opioid maintenance therapy are more likely than women treated with buprenorphine to deliver preterm. Preterm birth is associated with less risk of neonatal abstinence syndrome (NAS). We sought to assess the role of preterm birth as a mediator of the relationship between in utero exposure to methadone and NAS compared with buprenorphine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied 716 women receiving methadone or buprenorphine and delivering liveborn infants at Magee\u2010Womens Hospital, Pittsburgh, Pennsylvania (2013\u201315). We implemented inverse probability weighted marginal structural models to isolate the role of preterm birth (&lt;37\u00a0weeks\u2019 gestation). Weights accounted for confounding by maternal age, race, insurance, parity, delivery year, marital, employment, hepatitis C, and smoking status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Approximately 57% of the cohort were treated with methadone. Preterm birth was more common in methadone\u2010exposed pregnancies (25% versus 14%). The incidence of NAS treatment was higher in methadone compared with buprenorphine\u2010exposed infants (65% vs 49%), and term compared with preterm births (64% vs 36%). For every 100 infants liveborn to mothers treated for opioid dependence, there were 13 excess cases of NAS among infants exposed to methadone compared with buprenorphine (adjusted risk difference [RD] 13.3, 95% confidence interval [CI] 5.7, 20.9). Among term births, this increased to 17 excess cases of NAS in methadone\u2010 compared with buprenorphine\u2010exposed (RD 16.7, 95% CI 9.3, 24.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The further increased risk of NAS associated with methadone use vs buprenorphine in term deliveries emphasises the utility of buprenorphine in clinical settings aimed at decreasing NAS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12443","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T09:06:56Z","timestamp":1516957616000},"page":"213-222","source":"Crossref","is-referenced-by-count":26,"title":["The Role of Preterm Birth in the Association Between Opioid Maintenance Therapy and Neonatal Abstinence Syndrome"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-7787","authenticated-orcid":false,"given":"Lara S.","family":"Lemon","sequence":"first","affiliation":[{"name":"Department of 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