One-Year Postpartum Mental Health Outcomes of Mothers of Infants with Neonatal Abstinence Syndrome

Corr, Tammy E.; Schaefer, Eric; Hollenbeak, Christopher S.; Leslie, Douglas L.

doi:10.1007/s10995-019-02839-9

Cited by 21 publications

(14 citation statements)

References 39 publications

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“… 11 , 27 Along with a high number of ACEs, previous studies indicated a wide spectrum of mental health effects associated with opioid exposure such as major depression, anxiety, PTSD, and suicidal ideation. 52 , 53 However, we also found resilience among our participants. Despite the environments participants grew up in, some of the mothers were able to take a positive look into their past and attempted to adjust their present by seeking resources for both themselves and their infants.…”

Section: Discussionsupporting

confidence: 65%

Contextual risk and psychosocial profiles of opioid-using mothers: A mixed-methods study

Beltrán-Arzate

Hodson

Tes

et al. 2021

Womens Health (Lond Engl)

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Introduction: There is an increase in cases of mothers using opioids during pregnancy in the United States but research investigating mothers’ psychosocial environments along with individual variability among this high-risk group of women is scarce. Methods: This mixed-methods study aims to examine the complex interplay of contextual risks and experiences of opioid-using mothers. A sample of 50 opioid-using biological mothers of infants diagnosed with neonatal opioid withdrawal syndrome (NOWS) were studied using a set of standardized and open-ended questions, along with medical records extraction. Results: A high-risk subgroup of 36 mothers was identified using cluster analysis, characterized by a distinct profile of psychosocial risk. Thematic content analysis revealed four themes: (1) barriers to communication and mistrust of health professionals, (2) limitations of access to health care and the amplification of disadvantages related to COVID-19, (3) lifelong consequences of adverse childhood experiences (ACEs), and (4) intimate partner violence and its influence on drug use. Conclusion: Our findings highlight important information toward health services provision for opioid-using women of childbearing age. Efforts to reduce opioid usage in mothers need to consider psychosocial and contextual risks.

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Section: Discussionsupporting

confidence: 65%

Contextual risk and psychosocial profiles of opioid-using mothers: A mixed-methods study

Beltrán-Arzate

Hodson

Tes

et al. 2021

Womens Health (Lond Engl)

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“… 35 Contrary to our expectations, there was no significant difference between receipt of postpartum SUD treatment and attendance at the postpartum visit. This lack of an association is concerning; ideally, the postpartum visit should be an opportunity to ensure appropriate linkage to SUD treatment during this vulnerable period as well as to address prevalent co-occurring mental health conditions that, consistent with other literature, 10 , 36–38 were common in our study sample. It was also unexpected that months of Medicaid enrollment and number of prenatal visits were not associated with postpartum SUD treatment.…”

Section: Discussionsupporting

confidence: 61%

Postpartum Treatment for Substance Use Disorder Among Mothers of Infants with Neonatal Abstinence Syndrome and Prenatal Substance Exposure

Faherty

Heins

Kranz

et al. 2021

Women's Health Reports

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Background: Little is known about rates of substance use disorder (SUD) treatment for women in dyads affected by substance use in the immediate postpartum period. This study's objectives were to (1) identify characteristics of mothers of infants with neonatal abstinence syndrome (NAS) and/or prenatal substance exposure (PSE) who did or did not receive SUD treatment in the first 60 days postpartum and (2) describe timing of treatment receipt. Methods: This descriptive study examined linked mother-infant dyads using Medicaid data from Louisiana, Massachusetts, and Wisconsin for 2006-2009. Dyads were included if the infant had NAS and/or PSE. Descriptive statistics on sociodemographic characteristics, prenatal SUD, mental health conditions, Medicaid enrollment, and health care utilization were reported for women who did and did not receive SUD treatment in the first 60 days postpartum. The distribution of each variable was compared using chi-square tests. The timing of first postpartum treatment in weeks since delivery was examined. Results: Among Medicaid-insured women whose infants had in utero substance exposure, 15% received any postpartum SUD treatment. Fewer than half were diagnosed with SUD prenatally. Of those who received postpartum SUD treatment, 68% had received prenatal treatment. No association was observed between postpartum SUD treatment receipt and months of Medicaid enrollment in the year before delivery, prenatal visits, or postpartum visit attendance. Conclusions: Most women who likely need postpartum SUD treatment did not receive it and multipronged solutions are needed. These findings provide a useful baseline for evaluations of policies aimed at improving maternal health.

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“…One women in this study reported the exacerbation of mental health issues, secondary to anxiety and fear of being reported to child protective services. The tandem presence of anxiety in postpartum women with OUD has been previously reported 8,26 ; however, the associated of mental health issues and fear of being reported to child protective services warrants further exploration. Previous research finding suggests that psychological distress induced by a modifiable risk factor in the first year postpartum can be lessened by providing targeted interventions designed to minimize the effects of a trigger and decrease the burden of a negative outcome 11 …”

Section: Discussionmentioning

confidence: 88%

“…Implicit bias training may be one strategy, especially when used with additional approaches such as trauma‐informed care. Although the women in this study did not discuss IPV or sexual violence, these are previous or co‐occurring events for up to 70% of women with OUD 8–9,23 . Health care providers should recognize that not all women will disclose violence, but this history could be considered when caring for women with OUD.…”

Section: Discussionmentioning

confidence: 91%

“…For childbearing women with OUD, the postpartum period represents a time of increased vulnerabilities. In addition to the need for a woman's physical recovery, adaption to parenthood, and learning how to breastfeed, 7 postpartum women with OUD have an elevated risk of being diagnosed with a behavioral health disorder (depression, anxiety), 8 intimate partner violence (IPV), 9,10 social adversity (poverty, food insecurity), 11 or substance use relapse 12 . In fact, women with OUD overdose more frequently in the postpartum period when compared with pregnancy; the highest rate occurring at 7 to 12 months postpartum 13 .…”

Section: Introductionmentioning

confidence: 99%

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The Lived Experience of Postpartum Women Attending Outpatient Substance Treatment for Opioid or Heroin Use

Proulx

Fantasia

2020

J Midwife Womens Health

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Introduction The current opioid crisis and associated heroin epidemic have exhausted the limited community services that are available to substance users, with only about 12% of substance use treatment facilities offering special programs for pregnant women. Little information is known about the lived experience of postpartum women in outpatient substance use treatment programs, who are working toward abstinence and caring for a newborn. The purpose of this phenomenological study was to explore the lived experience of postpartum women attending outpatient substance use treatment for illicit opioid or heroin use. Methods Individual interviews were conducted between December 2017 and November 2018, with 10 postpartum women with opioid use disorder (OUD) engaged in outpatient substance use treatment programs. A 4‐step conceptual framework as suggested by Moustakas was used to understand and synthesize the lived experiences shared by the women. Results Five themes emerged from the raw data: the presence of a stigma in providers of health care services, a fear of being reported to family services, children are primary motivators to remain engaged in treatment, concern for the welfare of the infant, and barriers to treatment. Discussion Postpartum women with OUD and their infants have complex needs that may best be served by treatment programs that offer comprehensive care. The fear of being reported to family services and possible loss of custody influenced all aspects of their decision‐making.

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One-Year Postpartum Mental Health Outcomes of Mothers of Infants with Neonatal Abstinence Syndrome

Cited by 21 publications

References 39 publications

Contextual risk and psychosocial profiles of opioid-using mothers: A mixed-methods study

Contextual risk and psychosocial profiles of opioid-using mothers: A mixed-methods study

Postpartum Treatment for Substance Use Disorder Among Mothers of Infants with Neonatal Abstinence Syndrome and Prenatal Substance Exposure

The Lived Experience of Postpartum Women Attending Outpatient Substance Treatment for Opioid or Heroin Use

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