Impact of Group Prenatal Care on Neonatal Outcomes in Women With Opioid Use Disorder [17O

Abstract

INTRODUCTION: Opioid use disorder (OUD) is a growing problem that incurs several obstetric risks. The objective of this study was to determine the impact of group prenatal care (PNC) compared to conventional individual PNC on neonatal outcomes in women with OUD. METHODS: This was a retrospective cohort study evaluating a practice change to group PNC from individual PNC in pregnant patients with OUD at the Indiana University Maternal Recovery Program (MRP). IRB committee approval was obtained. Data were collected from pregnant patients at the MRP diagnosed with OUD, with initiation of care <32 weeks gestation, and receiving buprenorphine therapy. Our primary outcomes were the rate of neonatal abstinence syndrome (NAS) treatment requirement and NAS severity. Outcomes were compared between group and individual PNC patients using Student t-tests for continuous variables and chi-square tests for discrete variables. RESULTS: 252 OUD patients presented for PNC at the MRP from September 2015 to August 2017. 104 OUD patients presented for PNC from September 2017 to October 2018, following a practice change to group PNC. Among those meeting inclusion and exclusion criteria (n=304), 76 underwent group PNC and 228 underwent individual PNC. The two groups were similar in maternal demographics, substance use history, delivery characteristics, and antenatal buprenorphine dosing. There was a significant difference in the rate of NAS treatment requirement between the two groups of 40.8% for group PNC, compared to 54.8% for individual PNC (P=.0353). CONCLUSION: Women receiving group PNC for OUD may benefit from improved neonatal outcomes, specifically a decreased rate of NAS treatment requirement.