JMIR Publications

ABSTRACT

Background:

Although treatment for opioid use disorder (OUD) often yields high adherence during pregnancy, the risk of returning to opioid misuse during postpartum is high. There are currently no relapse prevention programs tailored to this unique time period. Using a prospective cohort study, we seek to preliminarily identify hormones and/or infant caregiving approaches as novel predictors of postpartum opioid misuse.

Objective:

As a first step in dissemination of results, this report contains a detailed account of the protocol, as well as recruitment, retention, compliance, and participant satisfaction.

Methods:

Participants were individuals with OUD (OUD+) and those without (OUD-) who were followed from late pregnancy (≥gestational week 36) to postpartum month five. From childbirth to postpartum week 12, participants completed daily surveys (capturing use, craving, interactions with infant) and weekly face-to-face visits (including collection of biological samples for hormone assays). Follow-up visits using the same procedures occurred at postpartum month four and five.

Results:

Most participants (50 OUD+, 20 OUD-) notified the study staff of childbirth (93%), completed at least one postpartum clinic visit (87%), and completed follow-up (73%). Compliance with procedures ranged from 81% for weekly surveys to 63% for weekly dried blood spots, generally with lower compliance among OUD+ and at later time points. Among a subgroup of participants (n=31), regardless of group and time point, reported high study satisfaction (e.g., on a scale where 0 is “not at all” and 3 is “extremely”, on average participants reported 2.9±0.4 for their willingness to complete this study again at week 12 postpartum).

Conclusions:

This prospective cohort study was well tolerated despite the challenging postpartum period. Data collected will provide ample opportunities to identify novel risk/protective factors to inform the development of new relapse prevention intervention programs specific to the needs of those with OUD during early postpartum.