ObjectivesTo compare pregnancy outcomes with medication assisted treatment using. methadone or buprenorphine in term mothers with opioid use disorder.MethodsA cohort of women receiving medication assisted treatment with either methadone or buprenorphine were identified from delivery records over a 10‐year period. Women were excluded with delivery ResultsThere were 260 women, 140 (53.8%) with methadone use and 120 (46.2%) with buprenorphine use. Groups were similar for maternal age, race, parity, homeless rate, tobacco use, mode of delivery and incidence of neonatal abstinence syndrome. The methadone group had a lower mean newborn birthweight (2874±459 g) and a greater incidence of low birth weight (11.4%) than the buprenorphine group (3282±452 g; p7 days (OR 3.61; 95% confidence interval 1.32–9.86; p=0.01).ConclusionsMedication assisted treatment favors buprenorphine use when compared to. methadone with an increased birthweight, reduced need for newborn treatment, and a shorter newborn length of stay in term infants.