The Pregnancy Recovery Center: A women-centered treatment program for pregnant and postpartum women with opioid use disorder

Elizabeth E Krans; Stephanie Bobby; Michael England; Robert H Gedekoh; Judy C Chang; Bawn Maguire; Patty Genday; Dennis H English

doi:10.1016/j.addbeh.2018.05.016

The Pregnancy Recovery Center: A women-centered treatment program for pregnant and postpartum women with opioid use disorder

Addict Behav. 2018 Nov:86:124-129. doi: 10.1016/j.addbeh.2018.05.016. Epub 2018 May 24.

Authors

Elizabeth E Krans¹, Stephanie Bobby², Michael England², Robert H Gedekoh², Judy C Chang³, Bawn Maguire², Patty Genday², Dennis H English²

Affiliations

¹ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA; Magee-Womens Research Institute, 204 Craft Ave, Pittsburgh, PA, 15213, USA. Electronic address: kransee@upmc.edu.
² Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA.
³ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA; Magee-Womens Research Institute, 204 Craft Ave, Pittsburgh, PA, 15213, USA.

PMID: 29884421
DOI: 10.1016/j.addbeh.2018.05.016

Abstract

Objective: To evaluate the impact of women-centered substance abuse treatment programming on outcomes among pregnant women with opioid use disorder (OUD).

Methods: We compared two retrospective cohorts of pregnant women with OUD on buprenorphine maintenance therapy who delivered an infant at the University of Pittsburgh from 2014 to 2016. Cohort 1 was composed of pregnant women who received women-centered OUD treatment services through the Pregnancy Recovery Program (PRC) and Cohort 2 was composed of pregnant women who received buprenorphine at OUD programs without women-centered services (non-PRC). Women-centered outcomes were defined as a) pregnancy-specific buprenorphine dosing, b) prenatal and postpartum care attendance, c) breastfeeding and d) highly effective contraception utilization. Chi-square and t-tests were used to compare outcomes between PRC and non-PRC patients.

Results: Among 248 pregnant women with OUD, 71 (28.6%) were PRC and 177 (71.4%) were non-PRC patients. PRC patients were significantly more likely to initiate buprenorphine during vs. prior to their pregnancy (81.4% vs. 44.2%; p < .01) and have a higher buprenorphine dose at the time of delivery (16.0 mg vs. 14.1 mg; p = .02) compared to non-PRC patients. Likewise, PRC patients were significantly more likely to attend their postpartum visit (67.9% vs. 52.6%; p = .05) and receive a long-acting reversible contraceptive (LARC) method (23.9% vs. 13.0%, p = .03) after delivery compared to non-PRC patients. Finally, PRC patients had a smaller percent decrease in the rate of breastfeeding during their delivery hospitalization (-14.7% vs. -37.1%).

Conclusions: Incorporating women-centered services into OUD treatment programming may improve gender-specific outcomes among women with OUD.

Keywords: Buprenorphine; Opioid use disorder; Postpartum; Pregnancy; Women-centered.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Analgesics, Opioid / therapeutic use*
Breast Feeding / statistics & numerical data
Buprenorphine / therapeutic use*
Contraception / statistics & numerical data
Contraceptive Effectiveness
Delivery of Health Care / methods*
Female
Humans
Opiate Substitution Treatment / methods
Opioid-Related Disorders / therapy*
Patient-Centered Care / methods*
Postnatal Care / statistics & numerical data
Postpartum Period*
Pregnancy
Pregnancy Complications / therapy*
Pregnant Women*
Prenatal Care / statistics & numerical data
Substance Abuse Treatment Centers
Young Adult

Substances

Analgesics, Opioid
Buprenorphine