Medications for opioid use disorder help mothers keep well-child visits
Click Here to Manage Email Alerts
Key takeaways:
- Prenatal MOUD use was associated with higher odds of infants receiving the recommended number of well-child visits.
- It was also associated with 4% lower odds of an ED visit during the first year of life.
Medications for opioid use disorder help mothers keep well-child visits in their infant’s first year of life, according to the results of a study published in JAMA Pediatrics.
Medications for opioid use disorder (MOUD) are recommended for pregnant mothers recovering from opioid use, with combination buprenorphine-naloxone therapy appearing safe in at least one study, but this population does face barriers to opioid use disorder (OUD) diagnosis and treatment.
“We know that MOUD are an effective form of treatment, and clinical evidence and policy guidelines have documented the importance of providing treatment and supportive services to mothers,” Mir M. Ali, PhD, a health economist in the Office of the Assistant Secretary for Planning and Evaluation at HHS, told Healio.
“However, little is known about how prenatal MOUD treatment influences outcomes for children, especially outcomes beyond the perinatal period,” Ali said. “We sought to fill this gap in the literature and examine when mothers are engaged in treatment and receiving the recommended care, are their children also likely to receive the appropriate levels of care?”
Ali and colleagues identified all live births from 2012 to 2019 in the Merative MarketScan multistate Medicaid database that included mothers with OUD and 9 months of continuous enrollment before childbirth. They looked to see if there was a valid link within 30 days between the mother’s delivery claim and the infant’s birth claims within the same family unit.
The study included 10,352 mother-child dyads, with 55.3% receiving no MOUD and the remaining 44.7% receiving MOUD. The researchers examined outcomes from the first year of life, including whether the infants had the recommended number of six well-child visits for children with prenatal opioid exposure, any ED visits or any inpatient care following the child’s birth.
Ali and colleagues found that prenatal MOUD use was associated with 20% higher odds of infants receiving the recommended number of well-child visits, 4% lower odds of an ED visit and 20% lower odds of readmissions during the first year of life.
“Providing mothers with the care that they need is not only beneficial for the mothers but is also beneficial for their children,” Ali said. “However, pregnant women with OUD face unique challenges in initiating and remaining in MOUD treatment, such as a lack of child care and other accessibility issues, financial barriers, stigma, and even criminal prosecution. Mitigating and helping patients navigate these barriers will improve outcomes for patients and their families.”
Ali his colleagues are interested in observing children for a longer period of time, such as when they reach preschool age at 3 years or school age at 5 years, he said.
“This will allow us to examine a wide array of developmental and behavioral outcomes for children,” Ali said.
Perspective
Back to Top
The importance of compliance with MOUD appears to positively affect infant care as well as maternal mortality and morbidity. If the patients care enough to take MOUD, they would likely be more interested in seeking postpartum care for themselves and their children.
However, the drawback for providers remains appropriate training and willingness to prescribe. I trained in Metro Detroit in the mid- to late 1990s and we had an obstetrical outpatient methadone clinic. I often saw patients in OB triage who tried to quit heroin or methadone cold turkey, which was traumatic. If they knew of an opportunity to receive MOUD, I believe many of them would have done it.
When it comes to any study, I am an advocate of the importance of avoiding racial disparity and the need for diversity in the study group as relevant and necessary. I would be interested in seeing a study in the post-COVID pandemic era and [whether] patients who are using it are possibly more prone to contracting COVID and worsening birth outcomes of babies. Rural opioid use rates are steadily increasing, so I think that population should be included in the study — not just urban-based patients.
Collapse
Read more about
Click Here to Manage Email Alerts