Facilitating treatment initiation and reproductive care postpartum to prevent substance-exposed pregnancies: A randomized bayesian pilot trial.

Autor: Stotts AL; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA. Electronic address: Angela.L.Stotts@uth.tmc.edu., Villarreal YR; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Green C; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Berens P; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Blackwell S; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Khan A; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Suchting R; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Velasquez M; The University of Texas at Austin, 1823 Red River St, Austin, TX 78712, USA., Markham C; UTHealth School of Public Health, 1200 Pressler, Houston, TX 77030, USA., Klawans MR; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA., Northrup TF; UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2022 Oct 01; Vol. 239, pp. 109602. Date of Electronic Publication: 2022 Aug 13.
DOI: 10.1016/j.drugalcdep.2022.109602
Abstrakt: Background: For non-treatment-seeking women who use substances during pregnancy, immediately postpartum may be an optimum time for intervention. Our study tested a novel, brief, hospital-initiated, adaptive motivational interviewing plus acceptance and commitment therapy (MIACT) intervention to facilitate treatment initiation and reproductive planning postpartum among mothers who used substances during pregnancy.
Methods: Mothers (N = 64) with an infant admitted to a neonatal intensive care unit were enrolled if they or their infant tested positive for an illicit substance at delivery or had a documented positive drug screen during pregnancy. A parallel group, randomized controlled design assigned participants to MIACT or conventional care (CC), with assessments at week 2 and 4 during treatment and follow-up at 2 and 6 months post treatment. Bayesian generalized linear modeling was used to evaluate outcomes as a function of treatment.
Results: Results indicated that during treatment the MIACT group demonstrated an 84% probability of benefit relative to CC with regard to initiating treatment (RR=1.5), however the effect was not seen at follow-up. MIACT was also associated with an increased probability of attending a postpartum obstetrics visit (RR=1.4), and receiving contraception during treatment and at both follow-ups, with posterior probabilities of 96% or higher and relative risks ranging from 1.5 to 5.1 at varying timepoints. Substance use rates for the MIACT versus CC were higher at follow-up.
Conclusions: Brief, hospital-initiated interventions can assist postpartum mothers who use substances to enter treatment and obtain contraception in order to reduce future substance-exposed pregnancies.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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