Opioid Use Disorder and Perinatal Outcomes

Area of Science:

• Perinatal health
• Maternal-fetal medicine
• Addiction medicine

Background:

• Limited evidence exists on perinatal health for mother-infant dyads affected by opioid use disorder (OUD).
• Increased risks of opioid-related harms necessitate identifying protective factors for pregnant individuals with OUD and their infants.
• Perinatal OUD incidence has been rising, demanding urgent research into effective interventions.

Purpose of the Study:

• To determine perinatal outcomes in women diagnosed with OUD.
• To investigate the association between opioid agonist treatment (OAT) and birth outcomes.
• To compare the effects of different OATs on infant health.

Main Methods:

• Population-based retrospective study using provincial health administrative data in British Columbia, Canada (2000-2019).
• Inclusion criteria: women with diagnosed OUD before delivery or during the puerperium.
• Logistic regression analysis controlled for demographic and clinical factors to assess OAT's impact on birth weight, gestational age, infant disorders, and neonatal abstinence syndrome (NAS).

Main Results:

• The study included 4574 women and 6720 live births; perinatal OUD incidence rose from 166 to 513 between 2000 and 2019.
• Continuous OAT during pregnancy was associated with reduced odds of preterm birth (aOR: 0.6; 95% CI: 0.4-0.8) and low birth weight (aOR: 0.4; 95% CI: 0.2-0.7) compared to discontinuing OAT.
• Buprenorphine-naloxone treatment showed reduced odds for preterm birth, low birth weight, and NAS compared to methadone.

Conclusions:

• Perinatal OUD incidence in British Columbia tripled over two decades.
• Sustained OAT during pregnancy is crucial for reducing adverse birth outcomes.
• Expanded OAT services are vital to support pregnant individuals with OUD and their infants.