What is the primary concern if a pregnant woman who is opioid-dependent does not continue her methadone regimen?

The primary concern if a pregnant woman who is opioid-dependent does not continue her methadone regimen is fetal demise. When a pregnant woman who is dependent on opioids stops taking her prescribed methadone, she risks destabilizing her opioid levels. Methadone helps maintain stability and reduces the likelihood of withdrawal symptoms, which can have severe consequences not just for the mother but also for the developing fetus.

Withdrawal from opioids can lead to significant fetal stress, which may precipitate adverse outcomes, including fetal distress and an increased risk of stillbirth or fetal demise. Continued use of methadone is crucial for the stabilization of both maternal and fetal health throughout pregnancy, as it mitigates the risks associated with opioid withdrawal and potential complications.

The concerns associated with withdrawal symptoms for the mother, increased risk of stillbirth, and neonatal abstinence syndrome are relevant but secondary to the most immediate risk of fetal demise if the methadone regimen is interrupted. Each of the other options, while important, reflects consequences that can arise from the primary concern of maintaining a stable environment for the fetus.