Characteristics and quality of life of opioid-dependent pregnant women in Austria

Metz, Verena E.; Comer, Sandra D.; Wuerzl, Johanna; Pribasnig, Anna; Fischer, Gabriele

doi:10.1007/s00737-014-0443-6

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…It is possible that the joys and responsibilities associated with child rearing may buffer against anhedonia in mothers in OMT. In support of this, a study of 390 Austrian mothers in OMT showed remarkably high self-reported quality of life [91]. Future studies should address the impact of psychosocial factors on reward responsiveness in current and former substance use disorder populations.…”

Section: Discussionmentioning

confidence: 78%

Intact responses to non-drug rewards in long-term opioid maintenance treatment

Eikemo

Lobmaier

Pedersen

et al. 2019

Neuropsychopharmacol.

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Disruption of non-drug reward processing in addiction could stem from long-term drug use, addiction-related psychosocial stress, or a combination of these. It remains unclear whether long-term opioid maintenance treatment (OMT) disrupts reward processing. Here, we measured subjective and objective reward responsiveness in 26 previously heroin-addicted mothers in >7 years stable OMT with minimal psychosocial stress and illicit drug use. The comparison group was 30 healthy age-matched mothers (COMP). Objective reward responsiveness was assessed in a two-alternative forced-choice task with skewed rewards. Results were also compared to performance from an additional 968 healthy volunteers (meta-analytic approach). We further compared subprocesses of reward-based decisions across groups using computational modelling with a Bayesian drift diffusion model of decision making. Self-reported responsiveness to non-drug rewards was high for both groups (means: OMT = 6.59, COMP = 6.67, p = 0.84, BF 10 = 0.29), yielding moderate evidence against subjective anhedonia in this OMT group. Importantly, the mothers in OMT also displayed robust reward responsiveness in the behavioral task (t 19 = 2.72, p = 0.013, BF 10 = 3.98; d = 0.61). Monetary reward changed their task behavior to the same extent as the local comparison group (reward bias OMT = 0.12, COMP = 0.12, p = 0.96, BF 10 = 0.18) and in line with data from 968 healthy controls previously tested. Computational modelling revealed that long-term OMT did not even change decision subprocesses underpinning reward behavior. We conclude that reduced sensitivity to rewards and anhedonia are not necessary consequences of prolonged opioid use.

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Section: Discussionmentioning

confidence: 78%

Intact responses to non-drug rewards in long-term opioid maintenance treatment

Eikemo

Lobmaier

Pedersen

et al. 2019

Neuropsychopharmacol.

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“…Patients’ self-reported outcomes have become an increasingly important source of information in health care [ 11 ]. QoL measures may provide insight into a broader perspective on physical, mental and social health [ 11 , 28 ], and may help to gradually shift the clinical focus from a cure to the enhancement of this outcome [ 29 ]. This view fits well with the recognition that substance misuse is a chronic, relapsing disorder that may have negative consequences on various life domains [ 29 , 30 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Quality of Life in High-Dose Benzodiazepine Misusers

Tamburin

Federico

Faccini

et al. 2017

IJERPH

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Benzodiazepines (BZDs) are among the most widely prescribed drugs in developed countries, but they have a high potential for tolerance, dependence and misuse. High-dose BZD misuse represents an emerging addiction phenomenon, but data on quality of life (QoL) in high-dose BZD misusers are scant. This study aimed to explore QoL in high-dose BZD misuse. We recruited 267 high-dose BZD misusers, compared the QoL scores in those who took BZD only to poly-drug misusers, and explored the role of demographic and clinical covariates through multivariable analysis. Our data confirmed worse QoL in high-dose BZD misusers and showed that (a) QoL scores were not negatively influenced by the misuse of alcohol or other drugs, or by coexisting psychiatric disorders; (b) demographic variables turned out to be the most significant predictors of QoL scores; (c) BZD intake significantly and negatively influenced QoL. Physical and psychological dimensions of QoL are significantly lower in high-dose BZD misusers with no significant effect of comorbidities. Our data suggest that the main reason for poor QoL in these patients is high-dose BZD intake per se. QoL should be considered among outcome measures in these patients.

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“…From a clinical point of view, our findings indicate that there is a need for the implementation of routine screening programmes to prevent vaginal infections in OMT women. These women constitute a select patient cohort facing high-risk pregnancies and a special need for early pregnancy care [ 36 ]. Cases of women first presenting for care at delivery should certainly be prevented, since the absence of prenatal care allows for an accumulation of risk factors, which in turn increases PTD risk and subsequent costs to society.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study

Farr

Kiss

Hagmann

et al. 2016

BMC Pregnancy Childbirth

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BackgroundVaginal infections are a risk factor for preterm delivery. In this study, we sought to evaluate the vaginal flora of pregnant women receiving opioid maintenance therapy (OMT) in comparison to non-dependent, non-maintained controls.MethodsA total of 3763 women with singleton pregnancies who underwent routine screening for asymptomatic vaginal infections between 10 + 0 and 16 + 0 gestational weeks were examined. Vaginal smears were Gram-stained, and microscopically evaluated for bacterial vaginosis, candidiasis, and trichomoniasis. In a retrospective manner, data of 132 women receiving OMT (cases) were matched for age, ethnicity, parity, education, previous preterm delivery, and smoking status to the data of 3631 controls. The vaginal flora at antenatal screening served as the primary outcome measure. Secondary outcome measures were gestational age and birth weight.ResultsIn the OMT group, 62/132 (47 %) pregnant women received methadone, 39/132 (29.5 %) buprenorphine, and 31/132 (23.5 %) slow-release oral morphine. Normal or intermediate flora was found in 72/132 OMT women (54.5 %) and 2865/3631 controls [78.9 %; OR 0.49 (95 % CI, 0.33–0.71); p < 0.001]. Candidiasis occurred more frequently in OMT women than in controls [OR 2.11 (95 % CI, 1.26–3.27); p < 0.001]. Findings were inconclusive regarding bacterial vaginosis (± candidiasis) and trichomoniasis. Compared to infants of the control group, those of women with OMT had a lower mean birth weight [MD −165.3 g (95 % CI, −283.6 to −46.9); p = 0.006].ConclusionsPregnant women with OMT are at risk for asymptomatic vaginal infections. As recurrent candidiasis is associated with preterm delivery, the vulnerability of this patient population should lead to consequent antenatal infection screening at early gestation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1003-z) contains supplementary material, which is available to authorized users.

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Characteristics and quality of life of opioid-dependent pregnant women in Austria

Cited by 5 publications

References 33 publications

Intact responses to non-drug rewards in long-term opioid maintenance treatment

Intact responses to non-drug rewards in long-term opioid maintenance treatment

Determinants of Quality of Life in High-Dose Benzodiazepine Misusers

Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study

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