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Steep increases in the prevalence of opioid use disorder (OUD) among pregnant women have serious consequences for maternal and infant health. This study analyzed linked maternal and infant Medicaid claims data and infant birth records in three states in the year before and after birth occurring 2014 to 2015. In the year before and after birth, 2% of mothers had an OUD diagnosis and 6% had a substance use disorder (SUD) diagnosis other than OUD. While 73% of women with OUD had some type of SUD treatment in the year before or after the birth, most had no treatment in an average enrolled month, and only 9% received any methadone treatment—currently the standard of care for OUD in pregnancy—in an average enrolled month. Pregnant women with OUD had delayed and lower rates of prenatal care compared to women with other SUDs, and their infants had higher NICU rates and longer birth stays compared to infants of mothers with other SUDs. There is urgent need for comprehensive, evidence-based OUD treatment integrated with maternity care.

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