Substance Use in Pregnant People - Optimizing Retention in Treatment by Maximizing Opportunities for Management
Washington University School of Medicine
Summary
Substance use during pregnancy is a leading cause of maternal morbidity and mortality in the United States, with 55-80% of postpartum patients disengaging from substance use disorder (SUD) treatment within one year of delivery. Structural and social determinants of health, including housing instability, transportation barriers, and limited childcare access, further exacerbate disparities in treatment retention. This pilot study, conducted in two specialized prenatal care clinics, evaluates the feasibility and acceptability of two integrated strategies to promote sustained engagement in recovery-oriented services during the perinatal and postpartum periods. Aim 1 implements a standardized social needs screening and referral protocol to connect patients with community-based supports. Aim 2 pilots a contingency management intervention to incentivize recovery-supportive behaviors. Findings will inform the design of a larger multi-site randomized controlled trial to evaluate the impact of these interventions on treatment retention, overdose prevention, and maternal-infant health outcomes.
Description
Substance use during pregnancy remains a significant public health concern and is among the leading causes of maternal morbidity and mortality in the United States. Despite the availability of evidence-based interventions-including pharmacotherapy and behavioral counseling-treatment discontinuation in the postpartum period remains prevalent. Data from prior studies indicate that between 55% and 80% of postpartum patients disengage from substance use disorder (SUD) treatment within the first year following delivery. Disparities in treatment retention are further exacerbated by structural and so…
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: Confirmed viable intrauterine pregnancy at any gestational age, or within three years postpartum SUD as defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders or clinician documentation Exclusion Criteria: Decline follow-up care at study site Require immediate hospitalization for unstable medical or psychiatric conditions making them clinically unsuitable to participate in a research study
Interventions
- OtherSocial drivers of health screening
Patients will undergo a structured and protocoled screening for social drivers of health and be linked to support services
- BehavioralPatients will undergo a program of contingency management
Patients will enter into a 12 week program of contingency management
Locations (2)
- University of MarylandBaltimore, Maryland
- Washington UniversitySt Louis, Missouri