Infant caregiving, relational factors, mood, and pain in perinatal opioid use disorder: A prospective cohort with ecological momentary assessment

IF 4.1 2区医学 Q1 PSYCHOLOGY, CLINICAL

Addictive behaviors Pub Date : 2026-06-01 Epub Date: 2026-02-12 DOI:10.1016/j.addbeh.2026.108639

Alicia M. Allen , Linnea B. Linde-Krieger , James Baurley , Jendar Deschenes , Stephanie Mallahan , Alma Anderson , Stacey Tecot , Lela Rankin

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引用次数: 0

Abstract

Evidence-based opioid use disorder (OUD) relapse prevention interventions designed to the unique needs of the postpartum period are lacking. We aimed to identify novel intervention targets using ecological momentary assessment (EMA) with Bayesian mixed-effects models to assess infant caregiving (e.g., skin-to-skin contact), relational factors (e.g., loneliness), and individual factors (e.g., pain): (1) by OUD status, and (2) in relation to craving and coping.

Participants with and without OUD (OUD+ and OUD−, respectively) were followed from late pregnancy to postpartum week 12 with daily EMA assessing infant caregiving, relational factors, individual factors, craving for non-therapeutic opioids (e.g., heroin), craving for therapeutic opioids (e.g., methadone), and coping with cravings.

Participants (n = 61) were 29.4 ± 5.1 years old. Compared to OUD− (n = 18), OUD+(n = 43) had greater infant-focused anxiety (β = 0.24, 95% CI: 0.002, 0.48) and well-being stress (β = 0.32; 95% CI: 0.02, 0.64). Coping with cravings declined over time (β = −0.38, 95% CI: −0.77, −0.01) whereas opioid cravings did not. Numerous associations were identified including, but not limited to, non-therapeutic craving with infant-focused anxiety (β = 1.95; 95% CI: 0.33, 3.55) and pain (β = 0.08; 95% CI: 0.03, 0.13), therapeutic craving with tangible support (β = 3.99; 95% CI: 0.56, 7.48) and work-related stress (β = 1.88; 95% CI: 0.63, 3.14), and coping with cravings with skin-to-skin contact (β = 0.07; 95% CI: 0.03, 0.11) and general well-being stress (β = −2.07; 95% CI: −4.12, −0.01).

Several modifiable risk factors had unique and meaningful associations with opioid cravings and coping with craving. Future research is needed to replicate these observations in diverse samples and examine the applicability to postpartum OUD recovery support.

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围产期阿片类药物使用障碍的婴儿护理、相关因素、情绪和疼痛：一项具有生态瞬时评估的前瞻性队列研究

缺乏针对产后独特需求的基于证据的阿片类药物使用障碍（OUD）复发预防干预措施。我们的目的是利用生态瞬时评估（EMA）和贝叶斯混合效应模型来确定新的干预目标，以评估婴儿护理（如皮肤接触）、相关因素（如孤独）和个体因素（如疼痛）：(1)通过OUD状态，(2)与渴望和应对有关。有和没有OUD的参与者（分别为OUD+和OUD -）从妊娠晚期随访到产后第12周，每日EMA评估婴儿护理，相关因素，个体因素，对非治疗性阿片类药物（如海洛因）的渴望，对治疗性阿片类药物（如美沙酮）的渴望，以及应对渴望。参与者（n = 61）年龄29.4±5.1岁。与OUD−(n = 18)相比，OUD+(n = 43)有更大的婴儿关注焦虑（β = 0.24, 95% CI: 0.002, 0.48）和幸福压力（β = 0.32, 95% CI: 0.02, 0.64）。对阿片类药物的渴望随着时间的推移而下降（β = - 0.38, 95% CI: - 0.77, - 0.01），而对阿片类药物的渴望则没有。确定了许多关联，包括但不限于，非治疗性渴望与婴儿焦虑（β = 1.95; 95% CI: 0.33, 3.55）和疼痛（β = 0.08; 95% CI: 0.03, 0.13），治疗性渴望与有形支持（β = 3.99; 95% CI: 0.56, 7.48）和工作压力（β = 1.88; 95% CI: 0.63, 3.14），以及通过皮肤接触来应对渴望（β = 0.07; 95% CI: 0.03, 0.11）和一般健康压力（β = - 2.07; 95% CI: - 4.12, - 0.01）。几个可改变的风险因素与阿片类药物渴望和应对渴望有着独特而有意义的联系。未来的研究需要在不同的样本中复制这些观察结果，并检验产后OUD恢复支持的适用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addictive behaviors 医学-药物滥用

CiteScore

8.40

自引率

4.50%

发文量

283

审稿时长

46 days

期刊介绍： Addictive Behaviors is an international peer-reviewed journal publishing high quality human research on addictive behaviors and disorders since 1975. The journal accepts submissions of full-length papers and short communications on substance-related addictions such as the abuse of alcohol, drugs and nicotine, and behavioral addictions involving gambling and technology. We primarily publish behavioral and psychosocial research but our articles span the fields of psychology, sociology, psychiatry, epidemiology, social policy, medicine, pharmacology and neuroscience. While theoretical orientations are diverse, the emphasis of the journal is primarily empirical. That is, sound experimental design combined with valid, reliable assessment and evaluation procedures are a requisite for acceptance. However, innovative and empirically oriented case studies that might encourage new lines of inquiry are accepted as well. Studies that clearly contribute to current knowledge of etiology, prevention, social policy or treatment are given priority. Scholarly commentaries on topical issues, systematic reviews, and mini reviews are encouraged. We especially welcome multimedia papers that incorporate video or audio components to better display methodology or findings. Studies can also be submitted to Addictive Behaviors? companion title, the open access journal Addictive Behaviors Reports, which has a particular interest in ''non-traditional'', innovative and empirically-oriented research such as negative/null data papers, replication studies, case reports on novel treatments, and cross-cultural research.