Paths to Recovery: Addiction Recovery Services and Prenatal Care Utilization Patterns among Pregnant Women Diagnosed with Opioid Use Disorder in South Texas and the Impact on Neonatal and Maternal Outcomes




Deem Bolton, Carma Sue

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Over the past two decades the United States has experienced a dramatic increase in the incidence of opioid misuse and opioid overdose deaths. One of the most impacted groups in the opioid epidemic are women of childbearing age. Mirroring the upward trend in opioid misuse and opioid overdose deaths is the number of women diagnosed with opiate use disorder and who become pregnant. Opioid use disorder among women who become pregnant is related to complications in the fetus including low birthweights, birth at early gestational ages, neonatal abstinence syndrome (NAS), and suspected cognitive differences. In Texas, Bexar County reports the highest number of infants born with NAS compared to the rest of the state. The Mommies program in San Antonio TX, a collaboration between the Center for Healthcare Services and University Health System, seeks to address this burden by providing recovery and prenatal care services to women who are pregnant and diagnosed with an opioid use disorder. A retrospective cohort study design was used to view the dynamics of recovery service and prenatal care attendance, as well as difference in prenatal care models on infant and maternal outcomes among low income, primarily Hispanic women within the Mommies Program. Logistic regression and Ordinary Least Square Regression were executed to view effects between a series of recovery service and clinical predictor and outcome variables. Results support the incorporation of services aimed at maternal education on clinical factors that impact mother and fetus prenatally and what to expect after delivery, as well as specialized female intensive outpatient programs. Both recovery services were found to have impacts on adherence to MAT recommendations. In addition, this study finds strong benefits in the incorporation of prenatal care services, linked by care coordination, and delivered by dedicated obstetric teams, into treatment programs to maximize recovery and clinical impacts during the prenatal and post-partum period.


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Hispanic, Opioid, Pregnancy, Prenatal Care, Program, Recovery