Abstract:
BACKGROUND:The goal of this study was to determine whether improved access to medication assisted therapy in the general population, with improved coordination of ancillary services for pregnant women, improved perinatal outcomes in a nonurban area. METHODS:The cohort of women treated for opioid dependence during pregnancy with medication-assisted therapy and delivered at a single institution between 2000 and 2006 were retrospectively identified (n = 149 women; n = 151 neonates). Access to opioid agonist therapy for the general population was determined as the combined number of available treatment positions for medication-assisted therapy. Treatment during pregnancy (interim substitution therapy vs opioid treatment program) and pregnancy outcomes were noted from chart review. The primary outcome of trend of prenatal care indices and newborn birth weight over time was determined by Kendall's tau. RESULTS:As access to treatment in the general population expanded from 2000 to 2006, the number of women receiving treatment increased, the proportion of women receiving interim substitution therapy decreased (P < 0.001), gestational age at the initiation of treatment decreased (P < 0.001), and the proportion of women receiving treatment before pregnancy increased (P < 0.001). Infants delivered to mothers in a treatment program had improved birth weight z score compared with those receiving interim substitution therapy (P = 0.007). The proportion of infants discharged to the care of the mother and remaining in maternal care at 1 year improved both over time (P = 0.03; P = 0.004) and with treatment within a treatment program (P < 0.001; P = 0.004). CONCLUSIONS:Improved access to opioid agonist treatment programs for the general population in nonurban areas improves perinatal outcome and retention of maternal guardianship.
journal_name
J Addict Medjournal_title
Journal of addiction medicineauthors
Meyer M,Benvenuto A,Howard D,Johnston A,Plante D,Metayer J,Mandell Tdoi
10.1097/ADM.0b013e3182541933subject
Has Abstractpub_date
2012-06-01 00:00:00pages
124-30issue
2eissn
1932-0620issn
1935-3227journal_volume
6pub_type
杂志文章abstract:OBJECTIVES:Women with opioid use disorder (OUD) in the USA are at risk for poor reproductive and sexual health (RSH) outcomes. The qualitative research presented here is part of a larger mixed methods study. The qualitative component used an implementation science framework to investigate provider and staff perspective...
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更新日期:2013-09-01 00:00:00
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更新日期:2012-09-01 00:00:00
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pub_type: 杂志文章,实务指引
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更新日期:2015-09-01 00:00:00
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更新日期:2013-05-01 00:00:00
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更新日期:2008-09-01 00:00:00
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更新日期:2020-09-01 00:00:00
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更新日期:2013-01-01 00:00:00
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更新日期:2014-09-01 00:00:00
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更新日期:2020-11-03 00:00:00
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更新日期:2019-03-01 00:00:00
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更新日期:2020-07-01 00:00:00
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更新日期:2019-01-01 00:00:00
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更新日期:2017-03-01 00:00:00
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更新日期:2015-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-07-01 00:00:00