Imagine being pregnant and trying to navigate opioid addiction. You need help, but what kind of help actually exists? A new review looked at the past decade of U.S. research to map out what interventions are being studied for pregnant women with opioid use disorder. It found 31 different studies, which the researchers sorted into categories based on who the intervention targets. More than half focused on the individual woman—things like coordinated clinical care or education. About a fifth looked at relationships, like group therapy. The rest examined community or society-level changes, like policies affecting access to medication. The review also noted that nearly half of these studies had mostly non-Hispanic white participants, which means we know less about what might work for other racial and ethnic groups. It's crucial to understand that this review is like creating a map of the territory—it shows us what kinds of help researchers are exploring, but it doesn't measure how well any of them actually work. The findings highlight that while getting medication is critical, many researchers are also looking at the bigger picture of social support and barriers. This gives us a clearer picture of where to focus future research to find the most effective help.
Scoping review maps 31 U.S. interventions for opioid use disorder during pregnancy by socioecological levelWhat helps pregnant women with opioid addiction? A new review maps the options
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Key Takeaway
Note: This scoping review maps OUD pregnancy interventions but does not establish effectiveness.
This scoping review examined 31 intervention studies for opioid use disorder during pregnancy in the United States, published between 2013 and 2023. The review categorized interventions using a socioecological model framework: individual-level (coordinated clinical care models, detoxification/tapering from MOUD, prenatal education), interpersonal-level (clinician education, group therapy), community-level (regional coordination of services), and society-level (policy change impact on MOUD access). No comparator was reported.
The analysis found that 17 studies (55%) focused on individual-level interventions, 6 studies (19%) on interpersonal-level interventions, and 8 studies (26%) on society/community-level interventions. Regarding participant demographics, 14 of the 31 included studies (45%) had over 75% non-Hispanic white participants. The review did not report primary outcomes, secondary outcomes, or follow-up duration.
Safety and tolerability data were not reported. Limitations were also not reported. The authors suggest that while MOUD access remains crucial, community-based interventions addressing broader social determinants and societal barriers may have the greatest impact on improving maternal health outcomes. However, this is a scoping review that maps and categorizes existing literature; it does not synthesize quantitative effectiveness data or establish causal evidence for any intervention. The review identifies a research gap in interventions for more diverse populations.
What this means for you:
A new review maps 31 ways to help pregnant women with opioid addiction, but doesn't say which work best. More on Opioid Use Disorder
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View Original Abstract ↓
BackgroundOpioid use disorder during pregnancy (OUD) continues to pose a significant public health challenge, requiring well-designed interventions. This scoping review identifies effective prenatal OUD interventions to promote the use of evidence-based approaches, such as medication for opioid use disorder (MOUD), and inform future research and clinical practice.MethodsWe searched PubMed, Embase, CINAHL, Scopus, and Web of Science for interventions for OUD during pregnancy from 2013 to 2023. Exclusions were non-English studies, animal research, non-prenatal interventions, pharmacological trials, and studies outside the U.S. Data were extracted on intervention context, sample, study aims, and results. We categorized each intervention by the socioecological model (SEM) level of implementation and applied the RE-AIM framework to evaluate reach, effectiveness, adoption, implementation, and maintenance.ResultsAfter review of 1,381 articles, a total of 31 intervention studies were included. Fourteen studies (45%) included over 75% non-Hispanic white participants. Seventeen studies (55%) were conducted at the individual level, six (19%) at the interpersonal level, and eight (26%) at the society/community level. Individual-level interventions focused on coordinated clinical care models, detoxification/tapering from (MOUD), and prenatal education. Interpersonal interventions included clinician education and group therapy. Community-level interventions targeted regional coordination of services, while society level studies examined the impact of policy change on MOUD access.ConclusionWe identified a wide range of prenatal OUD interventions with varying approaches and summarized each by SEM implementation level. While MOUD access remains crucial, community-based interventions that address broader social determinants, and societal barriers may have the greatest impact in improving maternal health outcomes.Systematic Review Registrationhttps://osf.io/, identifier 10.17605/OSF.IO/8ZUAB.
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