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Cited by 109Opioid Use Disorder TreatmentPrenatal Substance Exposure EffectsSubstance Abuse Treatment and Outcomes

Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder

Wilder, Christine, Lewis, Daniel, Winhusen, Theresa·2015·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2015.02.012
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Abstract

Background Increasing use of opioids has led to an increase in the number of pregnant and postpartum women in medication assisted treatment (MAT) for opioid use disorder.Methods We (1) conducted a systematic review of published literature on MAT discontinuation (methadone and buprenorphine) in pregnant and postpartum women and (2) determined methadone discontinuation rates in a retrospective cohort (2006-2013) of pregnant and postpartum women in a university affiliated methadone clinic.Results We found limited generalizable literature reports of discontinuation rates, with a range of prenatal discontinuation rates from 0 to 33% and rates which spanned various prenatal and postnatal periods from 26 to 64%. In our cohort of 229 women, 251 pregnancies were reported, with a prenatal methadone discontinuation rate of 11.0%. Based on a Cox proportional hazards model controlling for age, pregnancy outcome, and duration of treatment prior to delivery, the probability of methadone discontinuation at or before 6 months postpartum was 56.0%. Duration of methadone treatment prior to delivery was inversely associated with risk for postpartum discontinuation of treatment (HR = 0.98, 95% CI (0.96, 0.99)).Conclusions We conclude that the postpartum period is a time of increased risk for discontinuation of MAT. More accurate assessment of rates of pre- and postpartum MAT discontinuation, as well as further investigation of factors affecting these rates, is warranted. Development and testing of interventions to encourage early prenatal enrollment in MAT and improve postnatal retention in MAT would benefit pregnant women and new mothers with opioid use disorder.

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Authors
Wilder, C., Lewis, D., & Winhusen, T.
Affiliations
  • United States Department of Veterans Affairs (US)
  • University of Cincinnati (US)
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2015-04
Volume
149
Pages
225-231
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2015.02.012
OpenAlex
W2033891285
Cited by
109
References
49
Citations by year
2026: 7 · 2025: 12 · 2024: 7 · 2023: 13 · 2022: 14 · 2021: 21 · 2020: 14 · 2019: 9 · 2018: 9 · 2017: 3
FWCI
0.58
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
medication-assisted treatment, opioid use disorder, treatment discontinuation, pregnancy, postpartum period, methadone, buprenorphine, prenatal care, treatment duration, maternal health
MeSH terms
Buprenorphine, Female, Humans, Methadone, Narcotic Antagonists, Opioid-Related Disorders, Narcotics, Patient Dropouts, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Retrospective Studies, Postpartum Period, Kaplan-Meier Estimate, Opiate Substitution Treatment

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