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INTRODUCTION: Opioid use disorder (OUD) is a leading cause of maternal mortality. This study evaluated a new model of care for pregnant people with OUD, addiction-centered pregnancy care (ACPC), which provides assessment and support for the social, economic, and personal challenges linked to OUD within prenatal care. Unlike integrated models of care providing medication for OUD, ACPC is easier to implement and rapidly scalable. This study compared risk of preterm delivery and infant length of stay for patients receiving ACPC versus standard prenatal care. METHODS: In this retrospective cohort study approved by the Dartmouth Hitchcock IRB, data were abstracted from charts of patients with OUD who received ACPC (n=53) or standard prenatal care (n=41) and delivered at an academic medical center in the Northeast between 2018 and 2021. Risk of preterm delivery was examined using multivariate logistic regressions, and infant length of stay was assessed with negative binomial models. RESULTS: Women in the ACPC cohort had reduced odds of preterm delivery (n=3, 5.7%) compared to the standard prenatal cohort (n=11, 26.8%; odds ratio OR 0.40; 95% CI, 0.21, 0.80). Compared to standard prenatal care, infants of patients receiving ACPC stayed in the hospital fewer days after delivery (incidence risk ratio, 0.77; 95% CI, 0.61, 0.97). CONCLUSION: Among a cohort of pregnant patients with OUD in the Northeast, receiving ACPC was associated with reduced risk for preterm delivery and shorter length of infant hospitalization compared to standard prenatal care. Future research should assess if these differences are due to this model’s focus on supporting psychosocial and socioeconomic challenges linked to OUD.
Morgan et al. (Wed,) studied this question.