The DOI matches its Crossref record; 48 of the 49 references it cites were found in a registry or an index.
Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder
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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“Even when treatment is initiated, retention in treatment is low, decreasing most precipitously during the early postpartum period [2–6].”
Citations
Cites
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Maintenance agonist treatments for opiate dependent pregnant women
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Cited by
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Morgan, J. R., Schackman, B. R., Leff, J. A., Linas, B. P., & Walley, A. Y. (2018) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2017.07.001 · Cited by 332
Fatal and nonfatal overdose among pregnant and postpartum women in Massachusetts
Schiff, D. M., Nielsen, T., Terplan, M., Hood, M., Bernson, D., Diop, H., Bharel, M., Wilens, T. E., LaRochelle, M., Walley, A. Y., et al. (2018) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002734 · Cited by 327
Substance Use in Pregnancy: Identifying Stigma and Improving Care
Weber, A. N., Miskle, B., Lynch, A., Arndt, S. V., & Ación, L. (2021) · Substance Abuse and Rehabilitation · doi:10.2147/sar.s319180 · Cited by 201
Pregnancy-Associated Deaths Due to Drugs, Suicide, and Homicide in the United States, 2010–2019
Margerison, C. E., Roberts, M. H., Gemmill, A., & Goldman-Mellor, S. (2022) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000004649 · Cited by 142
Outcomes associated with the use of medications for opioid use disorder during pregnancy
Krans, E. E., Kim, J. Y., Chen, Q., Rothenberger, S. D., James, A. E., Kelley, D., & Jarlenski, M. (2021) · Addiction · doi:10.1111/add.15582 · Cited by 120
Metadata
- Authors
- Wilder, C., Lewis, D., & Winhusen, T.
- Affiliations
- United States Department of Veterans Affairs (US)
- University of Cincinnati (US)
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 149
- Pages
- 225-231
- ISSN
- 0376-8716 (ISSN-L)
- 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
- 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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