{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:25:57Z","timestamp":1793330757959,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To test the effect of the duration of medication for opioid use disorder (MOUD) use during pregnancy on maternal, perinatal and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort analysis of claims, encounter and pharmacy data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Pennsylvania, USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We analyzed 13\u2009320 pregnancies among 10\u2009741 women with opioid use disorder aged 15\u201344\u00a0years enrolled in Pennsylvania Medicaid between 2009 and 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>We examined five outcomes during pregnancy and for 12\u00a0weeks postpartum: (1) overdose, (2) postpartum MOUD continuation, (3) preterm birth (&lt;\u00a037\u00a0weeks gestation), (4) term low birth weight (&lt;\u00a02500\u00a0g at \u2265\u00a037\u00a0weeks) and (5) neonatal abstinence syndrome (NAS). Our primary exposure was the duration (count of weeks) of any MOUD use, including methadone or buprenorphine, during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Among 13\u2009320 pregnancies, 306 (2.3%) were complicated by an overdose, 1753 (13.2%) resulted in a preterm birth and 6787 (50.9%) continued MOUD postpartum. Among infants, 874 (7.6%) were low birth weight at term and 7706 (57.9%) were diagnosed with NAS. As the duration of MOUD use increased, we found a statistically significant decrease in the rate of overdose and preterm birth, a statistically significant increase in the rate of postpartum MOUD continuation and NAS and a decline in term low birth weight. Specifically, for each additional week of MOUD, the adjusted odds of overdose decreased by 2% [adjusted odds ratio (aOR)\u00a0=\u00a00.98; 95% confidence interval (CI)\u00a0=\u00a00.97, 0.99], preterm birth decreased by 1% (aOR\u00a0=\u00a00.99; 95% CI\u00a0=\u00a00.99, 1.00), postpartum MOUD continuation increased by 95% (aOR\u00a0=\u00a01.95; 95% CI\u00a0=\u00a01.87, 2.04) and NAS increased by 41% (aOR\u00a0=\u00a01.41; 95% CI\u00a0=\u00a01.35, 1.47). The odds of term low birth weight did not change (aOR\u00a0=\u00a01.00; 95% CI\u00a0=\u00a00.99, 1.00), although the rate declined with a longer duration of MOUD use during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Longer duration of medication for opioid use disorder use during pregnancy appears to be associated with improved maternal and perinatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15582","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T09:11:30Z","timestamp":1621933890000},"page":"3504-3514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":125,"title":["Outcomes associated with the use of medications for opioid use disorder during pregnancy"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8190-6039","authenticated-orcid":false,"given":"Elizabeth E.","family":"Krans","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, Magee\u2010Womens Research Institute University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Rothenberger","sequence":"additional","affiliation":[{"name":"Center for Research on Health Care Data Center, Division of General Internal Medicine University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Alton Everette","family":"James","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kelley","sequence":"additional","affiliation":[{"name":"Pennsylvania Department of Human Services Harrisburg PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-5447","authenticated-orcid":false,"given":"Marian P.","family":"Jarlenski","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1402780"},{"key":"e_1_2_8_3_1","unstructured":"American Society of Addiction Medicine (ASAM).National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.2015. 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