Duration of Medication Use for Opioid Use Disorder and Risk of Postpartum Overdose and Death.
Longer buprenorphine or naltrexone dispensing around delivery was associated with lower postpartum overdose or death hazard through one year.
Duration of Medication Use for Opioid Use Disorder and Risk of Postpartum Overdose and Death.
IMPORTANCE: Overdose is the leading cause of maternal mortality in the US, yet evidence on how medications for opioid use disorder (medications for opioid use disorder) affect postpartum overdose and mortality risk is limited.
To examine whether longer duration of medications for opioid use disorder dispensed during pregnancy and early post partum is associated with reduced overdose or death through 365 days post partum.
DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective cohort study of individuals delivering between 2007 and 2020, assessed through 1 year post partum or until the first outcome, through 2021.
full-length dispensing (132 days) roughly halved the hazard of postpartum overdose or death versus 1 day
The cohort included 9360 pregnancies among 7776 individuals (median [IQR] age at delivery, 27 [24-31] years).
The 1-year postpartum risk of death or overdose was 1.58% (148 individuals), with a median (IQR) time to event of 186.5 (92.5-258.8) days.
The median (IQR) medications for opioid use disorder duration during the 132-day exposure period was 88 (43-111) days.
Longer duration of medications for opioid use disorder receipt during pregnancy and early post partum was associated with lower risk of overdose or death in the first year post partum, underscoring the importance of supporting continuous medications for opioid use disorder treatment during this period.