{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T12:23:53Z","timestamp":1794227033472,"version":"4.9.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The emergence of xylazine, a veterinary alpha\u20102 and kappa opioid receptor agonist, as an adulterant in illicitly manufactured fentanyl has created new challenges and risks for pregnant people who use unregulated opioids. Xylazine test strips (XTSs) have been proposed as a harm reduction strategy, but their use has not been studied among pregnant and postpartum populations. The goals of this study were to assess the feasibility, acceptability, and efficacy of a novel Perinatal XTS intervention aimed at reducing xylazine exposure and associated harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pregnant and postpartum women with opioid use disorder and high risk of ongoing unregulated opioid use were recruited from inpatient units of a high\u2010volume maternity hospital in western Pennsylvania. Participants engaged in a standardized educational session about xylazine and XTS and then were given five XTS kits. Over a 2\u2010month period, participants were asked to complete a real\u2010time survey when they used an XTS to report test results and any associated drug use behavior change. All participants were asked to participate in an end\u2010of\u2010study survey and a semi\u2010structured interview about their experiences with Perinatal XTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 50 participants were enrolled, completed the education session, and accepted the XTS kits. Most participants were concerned about the potential impacts of xylazine on\n                      <jats:italic>pregnancy<\/jats:italic>\n                      and neonatal outcomes. Seventeen participants submitted a total of 71 real\u2010time surveys after using XTS to test drug samples. In the majority of cases, a positive result prompted behavioral change. Qualitative interviews with participants revealed six major themes: (1) Xylazine and XTS education was highly acceptable. (2) Desire for additional education related to xylazine. (3) XTS distribution and use were highly acceptable. (4) Impact of XTS on behavior change varied based on participant circumstances. (5) Concerns related to xylazine's impact on maternal health and treatment. (6) Concerns related to xylazine's impact on fetal and neonatal health.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings from this pilot study demonstrate that Perinatal XTS, a harm\u2010reduction intervention combining xylazine and XTS education and XTS kit distribution, is highly feasible to deliver, is acceptable among pregnant and postpartum women cared for in an obstetric healthcare setting, and has the potential to reduce risk\u2010related behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70274","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T04:09:48Z","timestamp":1774238988000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Xylazine test strip utilization among pregnant and postpartum women with opioid use disorder: A pilot study"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0075-2651","authenticated-orcid":false,"given":"Ilana","family":"Hull","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Magee\u2010Womens Research Institute and Foundation  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0421-1134","authenticated-orcid":false,"given":"Margaret","family":"Shang","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8190-6039","authenticated-orcid":false,"given":"Elizabeth","family":"Krans","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute and Foundation  Pittsburgh Pennsylvania USA"},{"name":"Department of Obstetrics Gynecology &amp; Reproductive Sciences University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Stewart","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute and Foundation  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Ritter","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute and Foundation  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0437-3173","authenticated-orcid":false,"given":"Lauren","family":"Narbey","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute and Foundation  Pittsburgh Pennsylvania USA"},{"name":"Department of Obstetrics Gynecology &amp; Reproductive Sciences University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Mayo","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute and Foundation  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6420-5385","authenticated-orcid":false,"given":"Raagini","family":"Jawa","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Center for Research on Healthcare University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.17045"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-023-03614-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:125504"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109380"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7226a4"},{"key":"e_1_2_8_7_1","volume-title":"Biden\u2013Harris Administration Designates Fentanyl Combined With Xylazine as an Emerging Threat to the United States","year":"2023"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addicn.2024.100155"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2014.03.015"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-023-00879-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2303120"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1127020"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(84)90712-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1292\/jvms.58.211"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2460\/ajvr.2002.63.1695"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.17161\/kjm.vol16.20624"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2024.2391156"},{"issue":"2","key":"e_1_2_8_18_1","first-page":"128","article-title":"Pharmacokinetics of Xylazine, 2,6\u2010Dimethylaniline, and Tolazoline in Tissues From Yearling Cattle and Milk From Mature Dairy Cows after Sedation With Xylazine Hydrochloride and Reversal With tolazoline hydrochloride","volume":"4","author":"Delehant T. M.","year":"2003","journal-title":"Veterinary Therapeutics: Research in Applied Veterinary Medicine"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2020.1753773"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001321"},{"issue":"5","key":"e_1_2_8_21_1","first-page":"1117","article-title":"Fentanyl Test Strip Use and Overdose History Among Individuals on Medication for Opioid Use Disorder","volume":"8","author":"Mistler C. B.","year":"2021","journal-title":"Austin Journal of Public Health and Epidemiology"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2018.09.009"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2020.106529"},{"key":"e_1_2_8_24_1","unstructured":"Shang M. 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