Dartmouth Medical School, Maine Dartmouth Family Medicine Residency, 149 North Street, Waterville, ME 04901, United States.
Maine Dartmouth Family Medicine Residency, 149 North Street, Waterville, ME 04901, United States.
J Subst Abuse Treat. 2018 Mar;86:26-29. doi: 10.1016/j.jsat.2017.12.001. Epub 2017 Dec 8.
To determine variables related to treatment retention in women six and twelve months postpartum that were in medication treatment using buprenorphine during pregnancy.
This retrospective cohort study of 190 maternal-infant dyads exposed to buprenorphine during pregnancy examines rates of treatment retention at six and twelve months postpartum and also analyzes a variety of potential predictors of treatment retention including illicit drug use in the third trimester, delayed entry into medication treatment and co-occurring mental health diagnoses requiring prescription medication.
At 12months postpartum, women appeared more likely to remain in medication treatment if they entered treatment early in pregnancy (defined as either being in treatment at the time of conception, p=0.001, or entering medication treatment prior to 13weeks gestation, p=0.037). Being prescribed an antidepressant medication during the third trimester was also associated with enhanced treatment retention at six months postpartum (p=0.005). At both six and twelve months postpartum, the use of illicit drugs (including opioids, cocaine and benzodiazepines) during the third trimester was negatively correlated with treatment retention (p=0.012 and p<0.001, respectively).
Early access to medication treatment is associated with treatment retention in women prescribed buprenorphine during pregnancy. This has important public health implications as access to treatment is limited in many parts of the country and many women are only able to obtain treatment after becoming pregnant. Being prescribed an antidepressant medication during pregnancy may enhance treatment retention, supporting the work of previous authors.
确定与妊娠期间使用丁丙诺啡药物治疗的女性产后 6 个月和 12 个月治疗保留相关的变量。
本研究回顾性分析了 190 例母婴双胎队列，这些母婴在妊娠期间暴露于丁丙诺啡，研究了产后 6 个月和 12 个月的治疗保留率，并分析了多种潜在的治疗保留预测因素，包括第三孕期的非法药物使用、延迟进入药物治疗以及需要处方药物的共病精神健康诊断。
在产后 12 个月时，如果女性在妊娠早期（定义为妊娠时已经开始治疗，p=0.001，或在妊娠 13 周前开始药物治疗，p=0.037）进入治疗，她们更有可能继续接受药物治疗。在第三孕期开处方抗抑郁药物也与产后 6 个月的治疗保留率增加相关（p=0.005）。在产后 6 个月和 12 个月时，第三孕期使用非法药物（包括阿片类药物、可卡因和苯二氮䓬类药物）与治疗保留呈负相关（p=0.012 和 p<0.001）。
早期获得药物治疗与妊娠期间开处方丁丙诺啡的女性的治疗保留率相关。这具有重要的公共卫生意义，因为在许多地区，治疗机会有限，许多女性只有在怀孕后才能获得治疗。在妊娠期间开处方抗抑郁药物可能会增强治疗保留率，这支持了以前作者的工作。
