Document Detail


Development of a Substance Abuse Program for Opioid-dependent Nonurban Pregnant Women Improves Outcome.
MedLine Citation:
PMID:  22517450     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The goal of this study was to determine whether improved access to medication assisted therapy in the general population, with improved coordination of ancillary services for pregnant women, improved perinatal outcomes in a nonurban area. METHODS:: The cohort of women treated for opioid dependence during pregnancy with medication-assisted therapy and delivered at a single institution between 2000 and 2006 were retrospectively identified (n = 149 women; n = 151 neonates). Access to opioid agonist therapy for the general population was determined as the combined number of available treatment positions for medication-assisted therapy. Treatment during pregnancy (interim substitution therapy vs opioid treatment program) and pregnancy outcomes were noted from chart review. The primary outcome of trend of prenatal care indices and newborn birth weight over time was determined by Kendall's tau. RESULTS:: As access to treatment in the general population expanded from 2000 to 2006, the number of women receiving treatment increased, the proportion of women receiving interim substitution therapy decreased (P < 0.001), gestational age at the initiation of treatment decreased (P < 0.001), and the proportion of women receiving treatment before pregnancy increased (P < 0.001). Infants delivered to mothers in a treatment program had improved birth weight z score compared with those receiving interim substitution therapy (P = 0.007). The proportion of infants discharged to the care of the mother and remaining in maternal care at 1 year improved both over time (P = 0.03; P = 0.004) and with treatment within a treatment program (P < 0.001; P = 0.004). CONCLUSIONS:: Improved access to opioid agonist treatment programs for the general population in nonurban areas improves perinatal outcome and retention of maternal guardianship.
Authors:
Marjorie Meyer; Anna Benvenuto; Diantha Howard; Anne Johnston; Dawn Plante; Jerilyn Metayer; Todd Mandell
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-18
Journal Detail:
Title:  Journal of addiction medicine     Volume:  -     ISSN:  1932-0620     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101306759     Medline TA:  J Addict Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Obstetrics and Gynecology (MM, AB, DP), Department of Biostatisitcs (DH), and Department of Neonatal Medicine (AJ), University of Vermont, Burlington; Department of Neonatal Medicine (JM), Fletcher Allen Health Care, Burlington, Vermont; and VT AHS- Division of Alcohol and Drug Treatment Programs (TM), Burlington.
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