Journal of substance use and addiction treatment · 2026
Recovery centered perinatal care: A retrospective cohort study evaluating a scalable prenatal care model to improve outcomes for birthing people with opioid use disorder and their newborns.
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Morgan Alexandra, Saunders Elizabeth C, Allan Katie, Nolan Eileen, Pfaff Mairead, Goodman Daisy J
Аннотация
INTRODUCTION: Opioid use disorder (OUD) during pregnancy poses numerous health risks for the pregnant person and their infant. Medication for OUD and adequate prenatal care have been shown to reduce the risks of adverse outcomes for pregnant patients and newborns, however the best model for these services is not yet established. One novel, low resource model is Recovery Centered Perinatal Care (RCPC) which combines prenatal care with peer recovery support and logistical support for social determinants of health often linked with negative outcomes of OUD including food insecurity, housing instability and intimate partner violence. This study compared the risk of preterm birth and infant length of stay in the hospital for participants receiving RCPC versus standard obstetric (OB) care.
METHODS: In this single center, retrospective cohort study, data were abstracted from charts of pregnant patients with OUD who delivered between 2018 and 2021. Patients received RCPC (n = 53) or standard prenatal care (n = 41) at the same rural academic medical center. Risk of preterm delivery was assessed using penalized maximum likelihood logistic regression and infant length of stay was assessed with negative binomial regression model.
RESULTS: The rate of preterm birth was significantly lower among patients receiving RCPC (n = 4, 7.1%) versus standard prenatal care (n = 11, 26.8%, p < 0.01), with multivariable models showing a decreased odds of preterm delivery in the RCPC cohort (OR = 0.40; 95% CI = 0.21, 0.8). Additionally, infants of patients receiving RCPC stayed in the hospital fewer days after birth (m = 4.4 days, sd = 1.5) than infants of patients receiving standard perinatal care (m = 8.3 days, sd = 14.1; IRR = 0.77; 95% CI = 0.61, 0.97).
CONCLUSIONS: Among a cohort of pregnant patients with OUD at a rural medical center, receiving recovery centered perinatal care was associated with reduced risk for preterm delivery and shorter length of infant hospitalization compared to standard prenatal care. This benefit may be due to the model's focus on supporting psychosocial and socioeconomic challenges linked to OUD.
METHODS: In this single center, retrospective cohort study, data were abstracted from charts of pregnant patients with OUD who delivered between 2018 and 2021. Patients received RCPC (n = 53) or standard prenatal care (n = 41) at the same rural academic medical center. Risk of preterm delivery was assessed using penalized maximum likelihood logistic regression and infant length of stay was assessed with negative binomial regression model.
RESULTS: The rate of preterm birth was significantly lower among patients receiving RCPC (n = 4, 7.1%) versus standard prenatal care (n = 11, 26.8%, p < 0.01), with multivariable models showing a decreased odds of preterm delivery in the RCPC cohort (OR = 0.40; 95% CI = 0.21, 0.8). Additionally, infants of patients receiving RCPC stayed in the hospital fewer days after birth (m = 4.4 days, sd = 1.5) than infants of patients receiving standard perinatal care (m = 8.3 days, sd = 14.1; IRR = 0.77; 95% CI = 0.61, 0.97).
CONCLUSIONS: Among a cohort of pregnant patients with OUD at a rural medical center, receiving recovery centered perinatal care was associated with reduced risk for preterm delivery and shorter length of infant hospitalization compared to standard prenatal care. This benefit may be due to the model's focus on supporting psychosocial and socioeconomic challenges linked to OUD.