No. 349-Substance Use in Pregnancy

Ordean, Alice; Wong, Suzanne; Graves, Lisa

doi:10.1016/j.jogc.2017.04.028

Cited by 76 publications

(55 citation statements)

References 113 publications

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“…Low rates of breastfeeding initiation among women receiving opioid maintenance therapy were also noted in Canada where, overall, 90.3% of women initiate breastfeeding . SOGC's policy paper reports that breastfeeding initiation among women on opioid maintenance therapy is as low as 20% to 75% and decreases further by 6 to12 weeks postpartum . A retrospective chart review of 94 women on methadone maintenance therapy conducted in Vancouver, Montreal, and Toronto who received care between 1997 and 2009 found a 17% initiation rate that did not vary significantly by city .…”

Section: Resultsmentioning

confidence: 99%

Breastfeeding in Women on Opioid Maintenance Therapy: A Review of Policy and Practice

Clark

2019

J Midwife Womens Health

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Introduction:Opioid use is epidemic in the United States. Opioid use disorder (OUD) in pregnancy, as well as neonatal abstinence syndrome, has quadrupled in the last decade, and opioid maintenance therapy is recommended for pregnant women with OUD. Breastfeeding is an important means of improving outcomes for these vulnerable women and newborns. The purpose of this study was to review current policy on breastfeeding and opioid maintenance therapy, the rates of breastfeeding among women in this population, and facilitators and barriers to implementing policy recommendations.Methods: CINAHL, PubMed, the Cochrane Database of Systematic Reviews, Embase, and Web of Science were searched. Inclusion criteria included publication between 2013 and 2018, English language, human only, and original data (except for policy statements). Studies were excluded if they did not report original data and did not examine breastfeeding for women on opioid maintenance therapy.Results: Eight policy statements and 17 original research studies were identified that met the search criteria. All the policy statements support breastfeeding for women who are stable on opioid maintenance therapy and do not have HIV. Despite this, rates of breastfeeding among women receiving opioid maintenance therapy remain low compared with women in the general population. Results of qualitative research indicates that women on opioid maintenance therapy face numerous barriers to breastfeeding, including misinformation from health care professionals. Quantitative research has only begun to identify interventions to improve breastfeeding outcomes in this population. Research was conducted primarily with white women receiving care at urban health care centers. Discussion:Practice lags behind policy in terms of supporting breastfeeding in women receiving opioid maintenance therapy. There is a need for more research that includes African American and rural women on opioid maintenance therapy, as well as quantitative research that uses findings from qualitative research to identify the best possible interventions for improving breastfeeding outcomes for women on opioid maintenance therapy and their newborns. One significant need is for health care provider education regarding these policies as well as best practices for providing breastfeeding education and support to this population. 545 RESULTSA total of 558 results were found, 154 duplicates were removed, and 404 titles and abstracts were screened. Of the 404 articles, 344 were excluded for failing to meet inclusion 546

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Section: Resultsmentioning

confidence: 99%

Breastfeeding in Women on Opioid Maintenance Therapy: A Review of Policy and Practice

Clark

2019

J Midwife Womens Health

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“…In this issue of JOGC, Alice Ordean, an international expert in this field, and her colleagues, provide thorough and updated guidelines for substance use in pregnancy, covering all aspects, from diagnosis to comorbidities, to management. 1 In this editorial, I will discuss several aspects of this guideline with some additional emphasis on existing evidence.…”

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confidence: 99%

“…Yet, Table 3 in the Guideline summarizes postnatal and long-term effects of different substances, not recognizing these challenges. 1 For example, under long-term child effects of marijuana the authors list "delinquency," while there are numerous studies showing that maternal cigarette smoking is associated with adolescent delinquency. 7 Because virtually all pregnant marijuana users consume cigarettes, it is not scientifically possible to assign marijuana as a cause for delinquency.…”

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confidence: 99%

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Substance Use in Pregnancy: Managing the High-Risk Patient

Koren

2017

Journal of Obstetrics and Gynaecology Canada

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“…Dans ce numéro du JOGC, Alice Ordean, experte internationale du domaine, et ses collègues présentent une directive clinique rigoureuse et à jour sur la consommation de substances pendant la grossesse, dans laquelle ils abordent les divers aspects de la prestation de soins, qu'il s'agisse du diagnostic, des comorbidités ou de la prise en charge 1 . Divers éléments de cette directive clinique seront abordés dans cet éditorial, qui explorera plus particulièrement certaines données actuelles.…”

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Consommation de substances psychoactives pendant la grossesse : Prise en charge de la patiente à risque élevé

Koren

2017

Journal of Obstetrics and Gynaecology Canada

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No. 349-Substance Use in Pregnancy

Cited by 76 publications

References 113 publications

Breastfeeding in Women on Opioid Maintenance Therapy: A Review of Policy and Practice

Breastfeeding in Women on Opioid Maintenance Therapy: A Review of Policy and Practice

Substance Use in Pregnancy: Managing the High-Risk Patient

Consommation de substances psychoactives pendant la grossesse : Prise en charge de la patiente à risque élevé

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