Medication-Assisted Treatment Use Among Pregnant Women With Opioid Use Disorder

Abstract

Adjusted prevalences derived from multivariable negative binomial regression model controlling for: year of delivery, age, race, ethnicity, Medicaid region, medical co-morbidities including psychiatric disorder, HCV and HIV infection and substance use history including tobacco, alcohol and polysubstance use.Krans EE, Kim JY, James AE, Kelley D, Jarlenski MP. Medication-assisted treatment utilization among pregnant women with opioid use disorder. Obstet Gynecol 2019; 133. The authors provided this information as a supplement to their article.

Trends in Diagnoses of Neonatal Abstinence Syndrome at Newborn Hospitalization in Maine, 2009-2018

“…Thus, in an attempt to differentiate these infants from those born to mothers with illicit opioid use, these cases may have been recorded in the billing claims data using one of the unspecified maternal drug use codes rather than the code for confirmed NAS (P96.1). 7 This practice could have increased over time because of increases in the prevalence of medication-assisted treatment in pregnant women 26 and in the general population. 27 Similarly, it is possible that unspecified maternal drug use codes were used to distinguish infants with NAS treated using the Eat Sleep Console method, which was implemented by most Maine hospitals between 2018 and 2019, 28 from those receiving standard pharmacological treatment.…”

Infective Endocarditis as a Complication of Intravenous Drug Use in Pregnancy: A Retrospective Case Series and Literature Review

“…38,39 Time and research have addressed many of these controversies; however, large proportions of pregnant women still do not receive opioid agonist therapies when hospitalized. [40][41][42][43][44] State-mandated reporting and the threat of civil or criminal penalties including the loss of child custody hinder the physician-patient therapeutic alliance and potentially discourage women from seeking and completing needed therapy for sequelae of OUD such as intravenous drug user (IVDU)associated IE. [45][46][47] As of May 2020, 25 states require healthcare providers to report suspected prenatal drug use and 23 states consider such child abuse under civil child-welfare statutes, whereas only 19 states have targeted drug treatment programs for pregnant women.…”

“… 38 39 Time and research have addressed many of these controversies; however, large proportions of pregnant women still do not receive opioid agonist therapies when hospitalized. 40 41 42 43 44 …”

Updates from the Literature, November/December 2020

“…Studies have also described racial and ethnic disparities in the treatment of OUD 6,7 . Recent research is documenting a similar trend among pregnant women, with women of color being less likely to receive medication to manage OUD and more likely to experience inconsistent use or discontinuation 8,9 …”