A retrospective analysis of treatment and retention outcomes of pregnant and/or parenting women with opioid use disorder

Abstract

Aim: To determine factors associated with positive outcomes of buprenorphine maintenance treatment for opioid use disorder among pregnant women and women with children under the age of five years.

Methods: This retrospective, de-identified electronic health record review of a cohort of 108 female patients at a suburban primary care outpatient clinic followed patients for one year of treatment at the clinic. Positive outcomes were defined as 1) treatment retention and 2) urine toxicology at 12 months free of all substances other than buprenorphine. This study also evaluated a variety of potential correlates of treatment retention and toxicology, including patient demographics, medical and social history, and clinical factors (i.e., participation in a women's group and assigned treatment provider).

Results: Patient retention was 73.2% at 12 months. Compared to those retained in treatment, patients not retained were more likely to have received past treatment for a psychiatric illness (65.4% vs. 38.2%; p < 0.02) or have prior criminal history of a misdemeanor conviction (56.0% vs. 27.9%; p < 0.02). There was a significant association between time in treatment and reduction in opiate use (p < 0.01).

Conclusions: In this population, certain baseline characteristics were predictive of failure to be retained in treatment. As such, specific patients may need more intensive treatment. These findings have important public health and child welfare implications and may offer insight for providers to tailor treatment and refer for comprehensive services.

Keywords: Buprenorphine; Maternal opioid use; Medication-assisted treatment; Opioid use disorder; Pregnancy.