Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy
Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy
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DOI：
10.1016/j.jsat.2017.12.001
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发表时间：
2018-03-01
影响因子：
3.9
通讯作者：
Knuppel, Kyle
中科院分区：
文献类型：
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作者：
O'Connor, Alane B.;Uhler, Brett;Knuppel, Kyle
目的：为了确定与产后6个月和12个月使用丁丙诺啡进行药物治疗的妇女的治疗保留相关的变量。这项回顾性队列研究包括190名产妇-在妊娠期间暴露于丁丙诺啡的婴儿二对检查了产后6个月和12个月的治疗保留率，并分析了治疗保留的各种潜在预测因素，包括第三个月的非法药物使用。三个月，延迟进入药物治疗和同时发生的精神健康诊断需要处方药。结果：在产后12个月，如果妇女在怀孕早期接受治疗，（定义为在受孕时正在接受治疗，p = 0.001，或在妊娠13周之前进入药物治疗，p = 0.037）。在妊娠晚期服用抗抑郁药物也与产后6个月的治疗保留率增加相关（p = 0.005）。在产后6个月和12个月，在妊娠晚期使用非法药物（包括阿片类药物，可卡因和苯二氮卓类药物）与治疗保持率呈负相关（分别为p = 0.012和p < 0.001）。结论：抢先体验药物治疗与妊娠期间服用丁丙诺啡的妇女的治疗保持率相关。这对公共卫生产生了重要影响，因为在该国许多地区获得治疗的机会有限，许多妇女只有在怀孕后才能获得治疗。在怀孕期间服用抗抑郁药物可能会提高治疗保留率，支持以前作者的工作。(C)2017爱思唯尔公司All rights reserved.
Aim: To determine variables related to treatment retention in women six and twelve months postpartum that were in medication treatment using buprenorphine during pregnancy.Methods: This retrospective cohort study of 190 maternal-infant dyads exposed to buprenorphine during pregnancy examines rates of treatment retention at six and twelve months postpartum and also analyzes a variety of potential predictors of treatment retention including illicit drug use in the third trimester, delayed entry into medication treatment and co-occurring mental health diagnoses requiring prescription medication.Results: At 12 months postpartum, women appeared more likely to remain in medication treatment if they entered treatment early in pregnancy (defined as either being in treatment at the time of conception, p = 0.001, or entering medication treatment prior to 13 weeks gestation, p = 0.037). Being prescribed an antidepressant medication during the third trimester was also associated with enhanced treatment retention at six months postpartum (p = 0.005). At both six and twelve months postpartum, the use of illicit drugs (including opioids, cocaine and benzodiazepines) during the third trimester was negatively correlated with treatment retention (p = 0.012 and p < 0.001, respectively).Conclusions: Early access to medication treatment is associated with treatment retention in women prescribed buprenorphine during pregnancy. This has important public health implications as access to treatment is limited in many parts of the country and many women are only able to obtain treatment after becoming pregnant. Being prescribed an antidepressant medication during pregnancy may enhance treatment retention, supporting the work of previous authors. (C) 2017 Elsevier Inc. All rights reserved.