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Association of Opioid Use Disorder-Related Service Trajectories During Pregnancy and Postpartum Health Service Use: A
Yuan Fang1, Alvin D Jeffery, Stephen W Patrick
1Department of Psychology, University of Notre Dame, Notre Dame, IN (YF); School of Nursing, Vanderbilt University, Nashville, TN (ADJ, JCP); Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN (ADJ); Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN (GMH, AAL); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA (SWP); Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, GA (SWP); Health Services Research Center, Emory University School of Medicine, Emory University, Atlanta, GA (SWP); Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN (JY, SO); and Massachusetts General Hospital and Harvard Medical School, Boston MA (ER).
Adherent medication for opioid use disorder (MOUD) during pregnancy, regardless of other services, reduced postpartum emergency visits and hospitalizations. Consistent MOUD use is key for better maternal health outcomes.
Area of Science:
- Obstetrics and Gynecology
- Addiction Medicine
- Health Services Research
Background:
- Opioid use disorder (OUD) during pregnancy presents complex challenges for maternal and infant health.
- Understanding treatment pathways is crucial for improving postpartum outcomes.
Purpose of the Study:
- To investigate the association between different opioid use disorder (OUD)-related service trajectories during pregnancy and postpartum emergency department (ED) visits and hospitalizations.
Main Methods:
- Utilized the Merative MarketScan Commercial Claims Database (2013-2021) for a cohort of pregnant individuals with OUD.
- Employed group-based multitrajectory modeling to identify distinct treatment and service utilization patterns during pregnancy.
- Examined the link between these trajectories and subsequent postpartum ED and hospitalization rates.
Main Results:
- Identified seven distinct opioid-related treatment and service trajectories among 2,531 pregnant individuals with OUD.
- Compared to high adherence MOUD initiation mid-pregnancy without ancillary services, receiving only services increased postpartum ED visits (HRED=1.34).
- Adherent MOUD use throughout or in the latter half of pregnancy was linked to significantly lower postpartum hospitalizations compared to other trajectories, including no MOUD or services.
Conclusions:
- Consistent medication for opioid use disorder (MOUD) during pregnancy, particularly in the latter half, is associated with improved postpartum outcomes.
- Adherence to MOUD, irrespective of other concurrent services, appears to be a critical factor in reducing postpartum ED visits and hospitalizations.
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