Multidisciplinary OUD Group Prenatal Care Decreases NICU Admissions and Duration of Treatment for NAS [25O

Abstract

INTRODUCTION: To compare neonatal characteristics among neonates born to women with opioid use disorder (OUD) on buprenorphine/naloxone medication assisted therapy (MAT) receiving traditional prenatal care (TPNC) or multidisciplinary OUD group (MOG) prenatal care. METHODS: A retrospective cohort analysis was performed of dyads treated with OUD on MAT who received TPNC or MOG prenatal care. MOG prenatal care is a comprehensive approach comprising of prenatal care and group counselling, social work, psychiatry, psychotherapy, mindfulness-integrated cognitive behavior therapy, pregnancy and OUD educational topics (breastfeeding, postpartum blues/depression, contraception, hepatitis C and Narcan administration). RESULTS: From July 2017 to June 2019, we identified 177 mother-infant dyads; 102 received TPNC and 75 received MOG prenatal care. Continuous data were analyzed for normality using the Shapiro-Wilk test. Student's t-test or Mann-Whitney U test were also employed. Categorical data analyzed with chi-square. Neonates born to mothers receiving MOG prenatal care were significantly less likely to require NICU admission (25.3% vs 41.2%, P=.048). Among neonates requiring NAS treatment, those born to mothers in MOG care had a significantly reduced duration of treatment (6 days vs 9 days, P=.001). Neonates born to mothers receiving MOG care were less likely to be treated for NAS, had a lower peak NAS score, higher birthweight and were less likely to be born prematurely; although these differences did not achieve statistical significance. CONCLUSION: Neonates born to mothers receiving MOG care were less likely to require NICU admission and had a shorter duration of NAS treatment.