TY - JOUR
KW - Adult
KW - Buprenorphine/therapeutic use
KW - Female
KW - Humans
KW - Methadone/therapeutic use
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Pregnancy
KW - Pregnancy Complications/drug therapy
KW - Prospective Studies
KW - Young Adult
AU - S. B. Brogly
AU - K. E. Saia
AU - M. M. Werler
AU - E. Regan
AU - S. Hernandez-Diaz
A1 - 
AB - OBJECTIVE: To describe the characteristics, treatment, and outcomes of pregnant women with opioid use disorder. METHODS: Women attending an obstetric and addiction recovery clinic in Boston from 2015 to 2016 were enrolled in a prospective cohort study and followed through delivery (N=113). Buprenorphine or methadone was initiated clinically. The Addiction Severity Index was administered at enrollment. Prenatal and delivery data were systematically abstracted from medical charts. RESULTS: Most women in the cohort were non-Hispanic white (80.5%) with a mean age of 28 years. Few women were married (8.9%). More than half of the cohort had been incarcerated, 29.2% had current legal involvement, and 15.0% generally had unstable housing. A majority (70.8%) were infected with hepatitis C and histories of sexual (56.6%) and physical (65.5%) abuse were prevalent. Regular substance used included heroin (92.0%), injection heroin (83.2%), other opioids (69.0%), marijuana (73.5%), alcohol (56.6%), and cocaine (62.8%). Fifty-nine women (52.2%) were treated initially with prenatal buprenorphine and 54 (47.8%) with methadone; 49.6% also were taking concomitant psychotropic medications. Employment (0.766±0.289) and psychologic (0.375±0.187) Addiction Severity Index scores were the highest, indicating the most severe problems in these areas. Opioid use relapse did not differ by treatment (44.7% overall). Thirteen (22.5%) of 59 women treated with buprenorphine transitioned to methadone mainly because of positive opioid screens. Overall, 23.0% (n=26) of the cohort discontinued clinical care. The number of pregnancy losses was small (three therapeutic abortions, four miscarriages, one stillbirth), with an overall live birth rate of 90.8% (95% CI 82.7-95.9). CONCLUSION: These data on the social circumstances, substance use, treatment, and treatment outcomes of pregnant women with opioid use disorder may help clinicians to understand and treat this clinically complex population.
AD - Department of Surgery, Queen's University, Kingston, Ontario, Canada; and the Department of Obstetrics & Gynecology, Boston University, the Department of Epidemiology, Boston University School of Public Health, and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
BT - Obstetrics and gynecology
C5 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
CP - 4
DO - 10.1097/AOG.0000000000002881
IS - 4
JF - Obstetrics and gynecology
LA - eng
M1 - Journal Article
N2 - OBJECTIVE: To describe the characteristics, treatment, and outcomes of pregnant women with opioid use disorder. METHODS: Women attending an obstetric and addiction recovery clinic in Boston from 2015 to 2016 were enrolled in a prospective cohort study and followed through delivery (N=113). Buprenorphine or methadone was initiated clinically. The Addiction Severity Index was administered at enrollment. Prenatal and delivery data were systematically abstracted from medical charts. RESULTS: Most women in the cohort were non-Hispanic white (80.5%) with a mean age of 28 years. Few women were married (8.9%). More than half of the cohort had been incarcerated, 29.2% had current legal involvement, and 15.0% generally had unstable housing. A majority (70.8%) were infected with hepatitis C and histories of sexual (56.6%) and physical (65.5%) abuse were prevalent. Regular substance used included heroin (92.0%), injection heroin (83.2%), other opioids (69.0%), marijuana (73.5%), alcohol (56.6%), and cocaine (62.8%). Fifty-nine women (52.2%) were treated initially with prenatal buprenorphine and 54 (47.8%) with methadone; 49.6% also were taking concomitant psychotropic medications. Employment (0.766±0.289) and psychologic (0.375±0.187) Addiction Severity Index scores were the highest, indicating the most severe problems in these areas. Opioid use relapse did not differ by treatment (44.7% overall). Thirteen (22.5%) of 59 women treated with buprenorphine transitioned to methadone mainly because of positive opioid screens. Overall, 23.0% (n=26) of the cohort discontinued clinical care. The number of pregnancy losses was small (three therapeutic abortions, four miscarriages, one stillbirth), with an overall live birth rate of 90.8% (95% CI 82.7-95.9). CONCLUSION: These data on the social circumstances, substance use, treatment, and treatment outcomes of pregnant women with opioid use disorder may help clinicians to understand and treat this clinically complex population.
PY - 2018
SN - 1873-233X; 0029-7844; 0029-7844
SP - 916
EP - 922
EP - 
T1 - Prenatal Treatment and Outcomes of Women With Opioid Use Disorder
T2 - Obstetrics and gynecology
TI - Prenatal Treatment and Outcomes of Women With Opioid Use Disorder
U1 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 30204704
U3 - 10.1097/AOG.0000000000002881
VL - 132
VO - 1873-233X; 0029-7844; 0029-7844
Y1 - 2018
Y2 - Oct
ER -