Early Access to Buprenorphine During Pregnancy Is Associated With Postpartum Treatment Retention

Among women with opioid use disorder, treatment with buprenorphine—compared with methadone—is associated with longer gestation, decreased preterm birth, and improved fetal outcomes including greater birth weight and head circumference. However, factors associated with postpartum treatment retention are unclear. Researchers conducted a retrospective chart review of all maternal and infant records for women prescribed buprenorphine during pregnancy within a family medicine residency program in rural Maine over an 8-year time period (2007–2015) to examine 6 and 12-month treatment retention. Women were excluded from the analysis if pregnancy was terminated, if buprenorphine treatment was terminated or the woman was transferred to buprenorphine treatment during pregnancy, or if the woman or infant required transfer to a tertiary care facility.

  • A total of 190 maternal-infant dyads were included; >95% of women were low-income and had Medicaid as primary or secondary insurer; >95% were Caucasian.
  • At 12 months postpartum, women were more likely to be retained in buprenorphine treatment if they entered treatment early in pregnancy (defined as either at the time of conception or prior to 13 weeks gestation).

Illicit substance use (including opioids, cocaine, and benzodiazepines) during the third trimester of pregnancy was associated with poorer treatment retention at both 6 and 12 months postpartum.

Comments: This study adds to the growing body of literature recommending early access to care for all people with opioid use disorder, but especially women of childbearing age.

Jeanette M. Tetrault, MD

Reference: O’Connor AB, Uhler B, O’Brien LM, and Knuppel K. Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy. J Subst Abuse Treat. 2018;86:26–29.

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