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Evidence-based care of pregnant women with opiate use disorder is in high demand. The dogma that detoxification during pregnancy is inadvisable due to adverse fetal effects has been called into question, as that guidance seemed to be based largely on anecdotal reports. Now, authors have conducted a systematic review of outcomes associated with opioid detoxification during pregnancy.
Data from nearly 2000 women (about half of whom underwent detoxification) in 15 studies were included. Substantial heterogeneity of detoxification methods and outcome assessment precluded meta-analysis. Detoxification completion rates varied widely, with significant risk for relapse (risk range for most studies, 30%–60%). Fetal death rates were similar among wome…