Metadona e Gravidez: Riscos e Alternativas Mais Seguras

Methadone maintenance therapy (MMT) is the standard of care for opioid use disorder (OUD) in pregnancy — not contraindicated. Abrupt cessation causes withdrawal, risking preterm labor, fetal distress, miscarriage.

Evidence‑Based Guidance

• Methadone: Full μ‑agonist; stabilizes maternal/fetal opioid levels; reduces illicit use, improves prenatal care engagement. Dose often needs increase in 3rd trimester (increased clearance).
• Buprenorphine: Partial agonist; alternative with lower neonatal abstinence syndrome (NAS) severity, less QT prolongation risk. Monotherapy (without naloxone) preferred.
• NAS: Expected with both; treatable with non‑pharmacologic care ± morphine. Breastfeeding encouraged (low milk levels).

MMT/buprenorphine + comprehensive prenatal care = best outcomes. Do not stop without medical supervision. The original statement is outdated and potentially harmful.