Powers Shelby A, Ivey Noel, Clifton Dana, Lumsden Rebecca
J Addict Med. 2025 Jun 23. doi: 10.1097/ADM.0000000000001523.
Peripartum opioid use disorder (OUD) is a significant public health concern. Although hospital admission for labor and delivery is common, little is known about hospitalized peripartum individuals with OUD or their inpatient management. The purpose of this study was to characterize hospitalized peripartum individuals with OUD who were seen by an OUD consult service and to examine their inpatient OUD treatment.
This was a retrospective cohort study of peripartum individuals who received an OUD consult from May 2020 to April 2022. All individuals were pregnant or up to 3 months postpartum at admission. Substance use and psychosocial history were collected, along with timing and acceptance of medication for opioid use disorder (MOUD) and details of discharge transitions.
Of the 23 peripartum individuals with OUD who received a consult during admission, 61% were white, 30% were black, and all were non-Hispanic. Most individuals (78%) had Medicaid. Only 30% were using MOUD at hospital admission. Two-thirds (63%) of those not using MOUD were started on treatment during hospitalization, most commonly with buprenorphine-naloxone. At discharge, most (74%) individuals were connected to outpatient OUD treatment. Of the total, 35% self-directed their discharge, and there was a higher proportion of self-directed discharges among those who did not receive inpatient MOUD compared with those who did (P < 0.01).
Hospitalization during the peripartum period is an important opportunity for initiation of MOUD and linkage to longitudinal, community OUD services. Further understanding of factors contributing to high rates of self-directed discharge in the peripartum period is needed.
围产期阿片类物质使用障碍（OUD）是一个重大的公共卫生问题。虽然因分娩住院很常见，但对于患有OUD的住院围产期患者及其住院管理情况却知之甚少。本研究的目的是描述接受OUD咨询服务的住院围产期OUD患者的特征，并检查他们的住院OUD治疗情况。
这是一项对2020年5月至2022年4月期间接受OUD咨询的围产期患者的回顾性队列研究。所有患者入院时均为怀孕或产后3个月内。收集了物质使用和社会心理病史，以及阿片类物质使用障碍药物治疗（MOUD）的时间和接受情况，以及出院过渡的细节。
在入院期间接受咨询的23名围产期OUD患者中，61%为白人，30%为黑人，均为非西班牙裔。大多数患者（78%）有医疗补助。只有30%的患者在入院时使用MOUD。三分之二（63%）未使用MOUD的患者在住院期间开始接受治疗，最常用的药物是丁丙诺啡 -纳洛酮。出院时，大多数（74%）患者与门诊OUD治疗机构建立了联系。总体而言，35%的患者自行安排出院，未接受住院MOUD治疗的患者自行出院的比例高于接受治疗的患者（P<0.01）。
围产期住院是启动MOUD治疗并与长期社区OUD服务建立联系的重要时机。需要进一步了解导致围产期自行出院率高的因素。
