SMFM Special Report: Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic

Although perinatal substance use disorders, particularly those that involve opioids, have become a major public health issue in the United States, comprehensive ,evidence-based guidance for the prevention and management of these disorders during pregnancy is lacking.Leaders in obstetric care, addiction medicine, mental health, and pediatrics gathered for a 2-day workshop,“Substance Use Disorders in Pregnancy,” that was held in conjunction with the Society for Maternal-Fetal Medicine’s 38th Annual Pregnancy Meeting. Given what has recently been termed an opioid epidemic, much of the workshop centered on identification and management of opioid use disorder (OUD) that included appropriate strategies to limit both opioid use and OUD. Goals of the workshop were to discuss critical issues that pertain to perinatal substance use disorders, with a focus on OUD in particular; to draft preliminary recommendations regarding screening, pain management, and medication-assisted therapy (MAT) forOUD during pregnancy; and to delineate research gaps.