Objective Opioid overdose deaths are a leading cause of maternal mortality in the US, with most occurring postpartum. Naloxone, an opioid antagonist, is an effective method to reverse an opioid overdose. The objective of our study was to examine the provision of naloxone information during prenatal care and identify the proportion of pregnant and postpartum individuals with opioid use disorder (OUD) who had a naloxone kit. Study Design Patient stakeholders co-designed survey questions covering education about and receipt of naloxone during the perinatal period (conception through 6 months after delivery). Individuals who had a history of OUD, received at least one prescription for medication for opioid use disorder (MOUD) during pregnancy and between 6 and 24 months postpartum were eligible for the study. Descriptive statistics were used to identify the proportion of participants who received naloxone education during prenatal care and time periods during which they had a kit. Chi-square tests were used to examine if overdose risk factors were associated with having a kit. Results Among 100 participants, 23% received naloxone information during prenatal care, and 14% during delivery hospitalization. Less than half of respondents (43%) reported having a kit during pregnancy and 28% during the first 6 months postpartum. Only 24% reported having a kit throughout the entire perinatal period. High risk participants who reported they did not take their MOUD as prescribed, discontinued their MOUD, returned to substance use, or experienced an overdose during the perinatal period were equally as unlikely to have a naloxone kit as their peers without these risk factors. Conclusion Perinatal individuals with OUD are not routinely receiving information about naloxone during prenatal care. Although the postpartum period is when perinatal individuals with OUD are at their greatest risk of death, they were least likely to have a kit during this time. Quality improvement initiatives targeting maternity care providers could increase the provision of naloxone and improve outcomes for individuals with OUD.
Language: en
", language="en", issn="0002-9378", doi="10.1016/j.ajog.2022.11.388", url="http://dx.doi.org/10.1016/j.ajog.2022.11.388" }