165 - Does Integrated Management of Opioid Use DIsorder Affects Outcome of the Newborn and Mothers?

Poster Number: 165
Publication Number: 165.233

Darshan Shah, East Tennessee State University James H. Quillen College of Medicine, Jonesborough, TN, United States; Monika Jain, East Tennessee State University James H. Quillen College of Medicine, Johnson City, TN, United States; Divya Agarwal, ETSU Quillen College of Medicine, Johnson City, TN, United States; Alyson J. Chroust, East Tennessee State University, Johnson City, TN, United States

Background: The opioid epidemic has affected maternal and infant health for more than a decade. Still, optimal management of opioid use disorder in pregnancy is debatable. Weaning of opioids during pregnancy has not been advocated by the American College of Obstetrics and Gynecology (ACOG) and the American Society of Addiction Medicine (ASAM) for opioid use disorder (OUD). Many of the affected women with OUD have coexisting psychiatric comorbidities.

Objective: The objective of the study was to compare the integrated management (IM) of OUD with weaning of opioids and behavioral therapy to non-weaning of opioids in opioid use disorder in pregnancy by looking at the maternal and infant outcomes.

Design/Methods: A group of mothers was recruited prenatally from the obstetric clinic of the university which partners with behavioral health in weaning opioids during pregnancy after IRB approval ( considered as the integrated management of OUD), while other groups which didn't receive behavioral health and weaning of opioids during pregnancy were recruited from the hospital. Mothers were given questionnaires regarding perceived stress, Edinburg postnatal depression (EPDS), and Confusion, Hubbub, and Order scale (CHAOS). Infants were followed for neonatal opioid withdrawal syndrome, need for morphine, and length of hospitalization. Both groups were compared by Chi-square and T-test for infant characteristics and ANOVA for the postnatal psychological outcome.

Results: A preliminary analysis of an ongoing study, where 20 of the 35 recruited mothers have delivered, showed significant differences in maternal health with a P of 0.02 for ANOVA for CHAOS scores for integrated management of OUD while scores for EPDS and perceived stress didn't show a significant difference in both the groups. Mothers in IM of OUD received a statistically significantly lower dose of opioid compared to non-IM of OUD (P < 0.0002). Infants delivered to IM of OUD exhibited a trend towards higher birth weight, no need for morphine (P < 0.05), and decreased length of hospitalization  (P -0.05))Conclusion(s): It appears in the preliminary analysis that integrated management of OUD improves the outcome of mothers with a lower dose of opioids along with improved CHAOS score after pregnancy in the postpartum period. Infant delivered are less likely to receive morphine for Neonatal Opioid Withdrawal Syndrome(NOWS) and decreased hospital length with the trend towards better weight gain.
Difference between two groups ; maternal and infant characteristics5f9eb1fe1217a24bb78d4ec23e42ec09-1.jpeg
Difference between two groups of mothers and infants5f9eb1fe1217a24bb78d4ec23e42ec09-0.jpeg