Comparison of Weaning and Nonweaning of Medication-Assisted Treatments in Pregnant and Postpartum Women With Opioid Use Disorder: A Systematic Review [ID: 1376658

Abstract

INTRODUCTION: The objective of this study was to perform a systematic review of studies reporting the maternal and infant outcomes associated with weaning (W) and nonweaning (NW) of medication-assisted treatments (MATs) in pregnant and postpartum women with opioid use disorder. METHODS: Studies done between the years 2000 and 2022 were extracted from PubMed using MeSH terms (neonatal abstinence syndrome, pregnancy, opioid disorder, and outcomes). Studies that reported maternal and infant outcomes associated with W and NW of MATs and done in English language were included. Thirty-eight studies out of 329 met the criteria. Data included study design, number of participants, and maternal and infant outcomes. SPSS was used to perform the analysis. RESULTS: Among the 38 studies included in this review, 8 were W studies, which included 1,214 participants, and 30 were NW, which included 5,727 participants. The average birth weight of infants was 3.07 kg (W group), 3.03 kg (NW group) (P=.01), and 3.3 kg (national average 2020); preterm deliveries were 13.6% (W group), 15.2% (NW group) (P=<.0001), and 10.1% (national rate 2020). Babies needing abstinence treatment was lower in W group (43.6% versus 51.6%, P=<.0001). Five in 286 deliveries in W group and 5 in 3,478 deliveries in NW group were recorded as pregnancy loss (P=<.0001). CONCLUSION: A statistically significant difference was observed between the preterm rates in MAT groups and the national average (P<.0001) and between pregnancy loss, average birth weight, and infants needing abstinence treatment of both groups. The W group had lower numbers of preterm babies, and babies needing abstinence treatment, and the average birth weight in W group was closer to the national average.