Does co-location of medication assisted treatment and prenatal care for women with opioid use disorder increase pregnancy planning, length of interpregnancy interval, and postpartum contraceptive uptake?
Women with opioid use disorder have higher rates of unplanned pregnancies, shorter interpregnancy intervals and lower rates of contraceptive use compared to women without substance use disorders. This contributes to worse perinatal and reproductive health outcomes for this population. It has been su...
Saved in:
| Published in: | Journal of substance abuse treatment Vol. 98; pp. 73 - 77 |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Elsevier Inc
01-03-2019
Elsevier Limited |
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Women with opioid use disorder have higher rates of unplanned pregnancies, shorter interpregnancy intervals and lower rates of contraceptive use compared to women without substance use disorders. This contributes to worse perinatal and reproductive health outcomes for this population. It has been suggested that co-location of medication assisted treatment (MAT) and reproductive health services could allow for improved outcomes among women with substance use disorders. The aim of this study was to determine if location where women received MAT influenced their pregnancy planning, interpregnancy interval or uptake of postpartum contraception between subsequent pregnancies.
We conducted a retrospective chart review at the University of Vermont Medical Center (UVMMC). Women were eligible for the study if they had two consecutive deliveries at UVMMC between 2009 and 2015 and if they received MAT during one or both pregnancies. Women in this community can receive MAT through a public MAT opioid treatment program (methadone or buprenorphine), a community MAT program (buprenorphine), or through an obstetric provider with co-location of prenatal care and MAT (buprenorphine). Demographics and maternal and neonatal outcomes were collected and descriptive statistics were performed.
A total of 98 women were included in the study. Of the women with documented pregnancy intention status, 84% were unplanned, for both pregnancies. Over half of women had a short interpregnancy interval (56.1%), defined as <18 months between consecutive pregnancies. Half of women (50%) did not receive any contraceptive method in the postpartum period. Furthermore, many patients (42.2%) desired long acting reversible contraception (LARC), but only 9.3% received it. Outcomes were not statistically different among the models of care.
Colocation of MAT with antenatal care did not improve pregnancy planning, interpregnancy interval, or uptake of postpartum contraception. Decisions regarding family planning and continued engagement with the health care system following pregnancy remain challenges in this group of women.
•Women on MAT have high rates of unplanned pregnancy and short interpregnancy intervals regardless of where they receive MAT care•Contraceptive uptake is low for postpartum women with opioid use disorders even when their prenatal care and MAT care is co-located•Integration of substance use treatment and prenatal care may improve other outcomes that were not examined in this study |
|---|---|
| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0740-5472 1873-6483 |
| DOI: | 10.1016/j.jsat.2018.12.001 |