Factors associated with medications for opioid use disorder (MOUD) treatment success during the pregnancy and postpartum periods: A scoping review

Background

Medications for opioid use disorder (MOUD) are a crucial intervention for pregnant and postpartum individuals with opioid use disorder (OUD). However, there is paucity of data on the factors associated with MOUD treatment success in this population. This scoping review aimed to evaluate factors associated with MOUD success during the pregnancy and postpartum period.

Methods

We completed a structured search of MEDLINE, CINAHL, PsycINFO, Web of Science, and ProQuest databases. Eligible studies included a metric of success in outpatient treatment in the pregnancy and postpartum period and were conducted in the United States after the Food and Drug Administration’s approval of buprenorphine in 2002. Reviewers independently screened studies for inclusion and extracted data. The primary outcome was treatment success (i.e., treatment adherence, abstinence from illicit opioids, or retention in care) during pregnancy and up to 12 months postpartum.

Results

Data from 15 studies were included. Medications included methadone, naltrexone and buprenorphine (mono or combination therapy). High daily dose of buprenorphine as mono or combination therapy, early initiation and longer duration of MOUD were associated with treatment success. Legal involvement, homelessness, and rural residency were negatively associated with treatment success. There were no differences in outcomes of individuals receiving telemedicine versus in-person care.

Conclusion

We identified several factors associated with MOUD treatment success among individuals with OUD during the pregnancy and postpartum periods. These factors may help guide future research and inform the development and adaptation of interventions tailored to better meet the needs of this key population.