MOUD During Pregnancy Associated With Reduced Family Separation After Birth

Infants of mothers who receive medications for opioid use disorder (MOUD) during pregnancy are more likely to be discharged home with their mothers relative to those who did not receive MOUD, according to research published in JAMA Health Forum.

As opioid use has become more prevalent among pregnant individuals, the number of infants entering foster care has subsequently increased. For pregnant individuals with opioid use disorder (OUD), clinicians recommend MOUD use during pregnancy as it is associated with improved outcomes for both parent and child. However, relatively little is known about the relationship between MOUD use during pregnancy and family separation after birth.

To address this knowledge gap, researchers conducted a study to determine whether use of MOUD during pregnancy is associated with higher rates of infants and mothers being discharged home together. The researchers used electronic health record data from Vanderbilt University Medical Center to identify all opioid-exposed infants who were born without critical illness at 35 weeks gestational age and later between March 1, 2018, and January 1, 2022. The primary exposure of interest was MOUD use during pregnancy and the primary outcome of interest was infant discharge home with their mother. The researchers also evaluated the interaction between MOUD and patient race, given previous evidence of racial disparities in receipt of MOUD.

A total of 459 mother-infant dyads were included in the analysis. Overall, 362 (78.9%) of mothers received MOUD during pregnancy (mean [SD] age=30.1 [4.8] years; 92.5% Non-Hispanic White) and 97 (21.1%) mothers did not receive MOUD (mean [SD] age=30.2 [5.5] years; 66.0% Non-Hispanic White).

Mothers who received MOUD during pregnancy were significantly more likely to be non-Hispanic White, covered by Medicaid, have infants born at higher gestational age, and be discharged home with their infant (all P <.001).

The researchers found that 82.9% of mothers who received MOUD were discharged home with their infants, compared with 51.5% of mothers who did not receive MOUD. This relationship was not significantly modified by race. Additionally, mothers who did not receive MOUD were more than 3 times as likely to have their infant discharged to foster care (18.6%) relative to those who received MOUD (5.0%).

These findings indicate that MOUD during pregnancy may help reduce family separation, as mothers receiving MOUD are more likely to be discharged with their infant relative to those not receiving MOUD. The researchers concluded, “Gaps in research on MOUD and child welfare outcomes may create barriers to funding for support services for families with OUD.”

Study limitations include the small sample size, misclassification bias, and heterogeneity of the treatment group.

This article originally appeared on Psychiatry Advisor