Listening to women and pregnant and postpartum people: Qualitative research to inform opioid use disorder treatment for pregnant and postpartum people

Guille, Constance; Buchanan, Casey H.; King, Courtney; Sujan, Ayesha C.; Brady, Kathleen T.; Newman, Roger B.

doi:10.1016/j.dadr.2022.100064

Cited by 4 publications

(2 citation statements)

References 60 publications

(33 reference statements)

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“…38 These conditions may be further exacerbated by symptoms that the mother may be experiencing, including peripartum pain or withdrawal, all of which can contribute to impeded maternal-infant bonding. [15][16][17] Longterm neurodevelopment outcomes in the child have not been clearly outlined. However, one study showed that infants with NAS were more likely to be hospitalized for assaults and maltreatment during adulthood.…”

Section: Neonatal Abstinence Syndrome (Nas)mentioning

confidence: 99%

“…Recent efforts to develop more effective methods for screening in this population have included web-based modalities that involve text-message and phone-based screening, treatment, and referral for pregnant patients with OUD. 15 Untreated OUD in the parturient is shown to be responsible for increased preterm births, maternal eclampsia, placental abruption, and fetal intrauterine growth restriction. 10 It is well documented that patients with OUD have better outcomes when they have a more open relationship with their physician.…”

Section: Introductionmentioning

confidence: 99%

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Multimodal Acute Pain Management in the Parturient with Opioid Use Disorder: A Review

Koltenyuk,

Mrad,

Choe

et al. 2024

JPR

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The opioid epidemic in the United States has led to an increasing number of pregnant patients with opioid use disorder (OUD) presenting to obstetric units. Caring for this complex patient population requires an interdisciplinary approach involving obstetricians, anesthesiologists, addiction medicine physicians, psychiatrists, and social workers. The management of acute pain in the parturient with OUD can be challenging due to several factors, including respiratory depression, opioid tolerance, and opioid-induced hyperalgesia. Patients with a history of OUD can present in one of three categories: 1) those with untreated OUD; 2) those who are currently abstinent from opioids; 3) those being treated with medications to prevent withdrawal. A patient-centered, multimodal approach is essential for optimal peripartum pain relief and prevention of adverse maternal and neonatal outcomes. Medications for opioid use disorder (MOUD), previously referred to as medication-assisted therapy (MAT), include opioids like methadone, buprenorphine, and naltrexone. These are prescribed for pregnant patients with OUD, but appropriate dosing and administration of these medications are critical to avoid withdrawal in the mother. Non-opioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used in a stepwise approach, and regional techniques like neuraxial anesthesia and truncal blocks offer opioid-sparing options. Other medications like ketamine, clonidine, dexmedetomidine, nitrous oxide, and gabapentinoids show promise for pain management but require further research. Overall, a comprehensive pain management strategy is essential to ensure the well-being of both the mother and the fetus in pregnant patients with OUD.

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