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- W4387211146 abstract "Opioid use disorder is a leading cause of death through the year postpartum.To identify the association of neighborhood-level social determinants of health and prenatal opioid use disorder treatment receipt with medication for opioid use disorder outcomes through the year postpartum among a cohort of birthing people.Population-based retrospective cohort study that utilized state Medicaid claims and enrollment data for the 1,690 individuals who delivered a live infant between July 1, 2016 to December 31, 2020 receiving medication for opioid use disorder at delivery. The primary exposure was the state Health Opportunity Index, a composite measure of social determinants of health linked at the census-tract level. Secondary exposures included comprehensiveness of opioid use disorder treatment and medication for opioid use disorder duration received prenatally. Outcomes included postpartum medication for opioid use disorder duration and continuity, operationalized as time from delivery to medication for opioid use disorder discontinuation and percentage of days covered by medication for opioid use disorder within the 12 months after delivery, respectively.Within the study sample, 711 deliveries were to birthing people living in the lowest state Health Opportunity Index tercile (indicating high burden of negative social determinants of health), 647 in the middle state Health Opportunity Index tercile, and 332 in the highest state Health Opportunity Index tercile. Using stepwise multivariable regression (Cox proportional hazards and negative binomial models) guided by a socioecological framework, prenatal receipt of more comprehensive opioid use disorder treatment and/or longer prenatal medication for opioid use disorder duration was associated with improved 1-year postpartum opioid use disorder treatment outcomes (medication for opioid use disorder duration and continuity). When the state Health Opportunity Index was added to the models, these significant associations remained stable, with the state Health Opportunity Index not demonstrating an association with the outcomes (Duration HR 1.39, 95% CI 0.551, 3.512; Continuity RR 1.024, 95% CI 0.323, 3.247).Targeted efforts at expanding access to and quality of evidence-based opioid use disorder treatments for reproductive-age people across the lifecourse should be prioritized within the spectrum of work aimed at eradicating disparities in pregnancy-related mortality." @default.
- W4387211146 created "2023-10-01" @default.
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- W4387211146 date "2023-09-01" @default.
- W4387211146 modified "2023-10-04" @default.
- W4387211146 title "Postpartum medication for opioid use disorder outcomes associated with prenatal treatment and neighborhood-level social determinants" @default.
- W4387211146 doi "https://doi.org/10.1016/j.ajogmf.2023.101173" @default.
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