{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:03:54Z","timestamp":1793307834225,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,4,12]],"date-time":"2020-04-12T00:00:00Z","timestamp":1586649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Texas Department of State Health Services","award":["2017-050043-001"],"award-info":[{"award-number":["2017-050043-001"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Between 2007 and 2016, pregnancy\u2010associated mortality resulting from overdose more than doubled in the United States. This study explored the circumstances surrounding maternal opioid\u2010related morbidity and mortality, using the life\u2010course theory as a sensitizing framework to examine how each participant's life\u2010course contributed to her substance use, relapse, recovery or overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A mixed\u2010methods study using semi\u2010structured, in\u2010depth face\u2010to\u2010face interviews and focus groups were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Texas, United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Women who had relapsed into opioid use or experienced a \u2018near\u2010miss\u2019 overdose and family members of women who had died during the maternal period due to opioid overdose were interviewed (<jats:italic>n<\/jats:italic>\u00a0=\u00a099).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>A socio\u2010demographic questionnaire captured participants\u2019 ethnicity, age, marital status, medical and mental health history and employment status. The Stressful Life Events Screening Questionnaire\u2014revised (SLESQ\u2010R) assessed life\u2010time exposure to trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Women reported histories of abuse and loss of a loved one through homicide or suicide. Participants indicated that limited social support, interpersonal conflict with their partner and unaddressed mental illness made recovery more challenging. Additionally, losing their children through the child welfare system was described as punitive and placed them at greater risk for relapse and overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A life\u2010course theory approach to examining maternal opioid\u2010related morbidity and mortality in Texas, United States reveals the complex needs of women at risk for opioid use relapse and overdose and the significant role of previous traumatic experiences.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15054","type":"journal-article","created":{"date-parts":[[2020,4,12]],"date-time":"2020-04-12T08:29:33Z","timestamp":1586680173000},"page":"2079-2088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["A life\u2010course theory exploration of opioid\u2010related maternal mortality in the United States"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4771-2016","authenticated-orcid":false,"given":"Lisa M.","family":"Cleveland","sequence":"first","affiliation":[{"name":"School of Nursing The University of Texas Health Science Center at San Antonio  San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"McGlothen\u2010Bell","sequence":"additional","affiliation":[{"name":"School of Pharmacology The University of Texas Health Science Center at San Antonio  San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia A.","family":"Scott","sequence":"additional","affiliation":[{"name":"School of Nursing The University of Texas Health Science Center at San Antonio  San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Recto","sequence":"additional","affiliation":[{"name":"School of Nursing The University of Texas Health Science Center at San Antonio  San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,12]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Pregnancy mortality surveillance system [internet]. Atlanta (GA): Centers for Disease Control and Prevention;2019[cited 2019 Aug 27]. Available at:https:\/\/www.cdc.gov\/reproductivehealth\/maternalinfanthealth\/pregnancy-mortality-surveillance-system.htm(Accessed: 6 March 2020)."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.09.028"},{"key":"e_1_2_8_4_1","unstructured":"Maternal Mortality and Morbidity Task Force Department of State Health Services. Joint biannual report. Austin TX: Department of State Health Services.2016: 1\u201322. Available at:https:\/\/dshs.texas.gov\/mch\/pdf\/2016BiennialReport.pdf."},{"key":"e_1_2_8_5_1","unstructured":"Maryland Department of Health and Mental Hygiene Prevention Health Promotion Administration. Maryland Maternal Mortality Review 2015 Annual Report. Maryland.2015;13\u20131207. Available at:https:\/\/phpa.health.maryland.gov\/mch\/Documents\/2015MMR_FINAL.pdf."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001695"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002734"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003279"},{"key":"e_1_2_8_9_1","unstructured":"Office of Women's Health.Final Report: Opioid use Misuse and Overdose in Women. Washington DC: Department of Health and Human Services;2017 86 pp. Available at:https:\/\/www.womenshealth.gov\/files\/documents\/final\u2010report\u2010opioid\u2010508.pdf."},{"key":"e_1_2_8_10_1","first-page":"1419","article-title":"Drug and opioid\u2010involved overdose deaths\u2014United States, 2013\u20132017","volume":"67","author":"Scholl L.","year":"2019","journal-title":"Morb Mortal Wkly Rep"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_8_12_1","unstructured":"FineA. KotelchuckM.Rethinking MCH: The Life Course Model as an Organizing Framework. Washington DC: US Department of Health and Human Services Health Resources and Services Administration Maternal and Child Health Bureau;2010 pp.1\u201320."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.09.021"},{"key":"e_1_2_8_14_1","unstructured":"Sex and gender differences in substance use [internet]. North Bethesda MD: National Institute on Drug Abuse.2018[cited 2019 Aug 27]. Available at:https:\/\/www.drugabuse.gov\/publications\/research\u2010reports\/substance\u2010use\u2010in\u2010women\/sex\u2010gender\u2010differences\u2010in\u2010substance\u2010use."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024456713321"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00131"},{"key":"e_1_2_8_17_1","volume-title":"Analyzing and Reporting Focus Group Results","author":"Morgan D. L.","year":"1998"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/104973201129119299"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.4770180211"},{"key":"e_1_2_8_20_1","first-page":"151","article-title":"The systems framework","author":"White J. M.","year":"2008","journal-title":"Family Theor"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.20751"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521-0391.2011.00141.x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2007.03.009"},{"key":"e_1_2_8_24_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).SAMHSA's Concept of Trauma and Guidance for a Trauma\u2010Informed Approach. Publication No. (SMA) 14\u20134884. Rockville MD: SAMHSA;2014."},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2013.800116"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2006.06.015"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.05.016"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000086"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb03268.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.04041.x"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANS.0000000000000118"},{"key":"e_1_2_8_32_1","unstructured":"RadelL. BaldwinM. CrouseG. GhertnerR. WatersA.Substance Use the Opioid Epidemic and the Child Welfare System: Key Findings From a Mixed Methods Study. Washington DC: Office of the Assistant Secretary for Planning and Evaluation;2018."},{"key":"e_1_2_8_33_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Webinar on Parenting in Recovery: Challenges and Opportunities [internet]. Rockville (MD): SAMHSA;2016[cited 2020 Feb 3]. Available at:https:\/\/recoverymonth.gov\/events\/webinar\u2010parenting\u2010recovery\u2010challenges\u2010opportunities."},{"key":"e_1_2_8_34_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Recovery\u2010oriented Practice: Person\/Family Centered Recovery Planning [internet]. Rockville (MD): SAMHDA [cited 2020 Feb 3]. Available at:https:\/\/www.samhsa.gov\/sites\/default\/files\/programs_campaigns\/recovery_to_practice\/creating\u2010recovery\u2010oriented\u2010plans\u2010community\u2010resources.pdf."},{"key":"e_1_2_8_35_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Recovery Supports for Children and Families [internet]. Rockville MD: SAMHSA;2012[cited 2020 Feb 3]. Available at:https:\/\/www.samhsa.gov\/brss\u2010tacs\/video\u2010trainings#parents\u2010families."},{"key":"e_1_2_8_36_1","unstructured":"MOMSOhio.Building teams for health moms and babies [internet]. Ohio: MOMSOhio [cited 2020 Feb 3]. Available at:http:\/\/momsohio.org\/."},{"key":"e_1_2_8_37_1","unstructured":"The Mommies toolkit: Improving outcomes for families impacted by neonatal abstinence syndrome [Internet]. Austin (TX): Texas Department of State Health Services;2015[cited 2020 Feb 3]. Available at:https:\/\/hhs.texas.gov\/sites\/default\/files\/documents\/services\/mental\u2010health\u2010substance\u2010use\/mommies\u2010toolkit\u2010neonatal\u2010abstinence\u2010syndrome.pdf."},{"key":"e_1_2_8_38_1","unstructured":"Guttmacher Institute. Substance use in pregnancy: State Laws and Policies [Internet]. Washington DC: Guttmacher Institute;2020[cited 2020 Feb 3]. Available at:https:\/\/www.guttmacher.org\/state\u2010policy\/explore\/substance\u2010use\u2010during\u2010pregnancy."},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2019.02.005"},{"key":"e_1_2_8_40_1","unstructured":"Legal Action Center.Department of Justice addresses MAT discrimination [internet]. New York NY: Legal Action Center;2019[cited 2020 Feb 3]. Available at:https:\/\/lac.org\/department\u2010of\u2010justice\u2010addresses\u2010mat\u2010discrimination\/."},{"key":"e_1_2_8_41_1","unstructured":"Legal Action Center.Advocating for your recovery when ordered off addiction medication [internet]. New York NY: Legal Action Center;2018[cited 2020 Feb 3]. Available at:https:\/\/lac.org\/wp\u2010content\/uploads\/2016\/10\/MAT\u2010AdvocatingforYourRecovery.pdf."},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042533313479197"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.15054","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.15054","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.15054","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.15054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T23:18:06Z","timestamp":1693955886000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.15054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,12]]},"references-count":41,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/add.15054"],"URL":"https:\/\/doi.org\/10.1111\/add.15054","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,12]]},"assertion":[{"value":"2019-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}