Trends in Opioid Agonist Treatment for Opioid Dependence During Pregnancy: A Population-Based Study in New South Wales 2005–2021

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review Pub Date : 2026-03-09 DOI:10.1111/dar.70139

Duong Thuy Tran, Bianca Varney, Nicola Jones, Chrianna Bharat, Jonathan Brett, Ju-Lee Oei, Sallie-Anne Pearson, Louisa Degenhardt, Alys Havard

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Abstract

Introduction

The objective of this study was to examine trends in opioid agonist treatment (OAT) during pregnancy for opioid dependence, by OAT type (methadone, buprenorphine) and during-pregnancy OAT type change.

Methods

Data linkage study. The cohort included pregnancies resulting in childbirth among people who received OAT within 4 years prior to birth, New South Wales, 1 January 2005–31 December 2021. We calculated the prevalence of OAT during pregnancy by OAT type and year of birth; prevalence rate ratios (PRR) and proportions experiencing OAT type change during pregnancy.

Results

The cohort included 5212 childbirths among 3303 people. OAT was received in 4102 (78.7%) pregnancies. The annual prevalence of OAT during pregnancy was 77.2% in 2005, 86.2% in 2012 and 63.2% in 2021 (PRR 0.99; 95% confidence interval [CI] 0.99–1.00). Between 2005 and 2021, methadone use during pregnancy decreased from 70.9% to 37.4% (PRR 0.97; 95% CI 0.96–0.98) while buprenorphine use increased from 12.3% to 29.3% (PRR 1.07; 95% CI 1.06–1.08). Overall, changes in OAT type occurred in 226 pregnancies (5.5%). Among 971 pregnancies initially on buprenorphine, methadone was later used among 193, with this proportion decreasing over time. Of the 3131 pregnancies initially on methadone, buprenorphine was later used among only 33.

Discussion and Conclusions

Three in four people in the cohort received OAT during pregnancy, with no statistically significant change in annual prevalence over the 2005–2021 period. Given prior evidence indicating higher rates of treatment discontinuation with buprenorphine versus methadone, the increased buprenorphine use during pregnancy highlights the need for targeted strategies to support treatment retention.

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阿片类药物激动剂治疗怀孕期间阿片类药物依赖的趋势：2005-2021年新南威尔士州一项基于人群的研究。

简介：本研究的目的是通过OAT类型（美沙酮，丁丙诺啡）和妊娠期间OAT类型的变化，研究阿片受体激动剂治疗（OAT）在妊娠期间阿片类药物依赖的趋势。方法：数据关联研究。该队列包括2005年1月1日至2021年12月31日在新南威尔士州接受OAT治疗的产前4年内怀孕分娩的人。我们按OAT类型和出生年份计算妊娠期OAT的患病率；患病率比（PRR）和怀孕期间经历OAT类型变化的比例。结果：该队列包括3303人中5212名新生儿。4102例（78.7%）妊娠接受OAT。妊娠期OAT年患病率2005年为77.2%，2012年为86.2%，2021年为63.2% （PRR 0.99； 95%可信区间[CI] 0.99-1.00）。2005年至2021年间，妊娠期间美沙酮的使用从70.9%下降到37.4% (PRR 0.97; 95% CI 0.96-0.98)，丁丙诺啡的使用从12.3%上升到29.3% （PRR 1.07; 95% CI 1.06-1.08）。总体而言，226例妊娠发生OAT类型变化（5.5%）。在971例最初使用丁丙诺啡的孕妇中，193例后来使用美沙酮，这一比例随着时间的推移而下降。在3131名最初服用美沙酮的孕妇中，只有33名后来使用了丁丙诺啡。讨论和结论：该队列中四分之三的人在怀孕期间接受了OAT治疗，2005-2021年期间的年患病率没有统计学上的显著变化。鉴于先前的证据表明丁丙诺啡治疗中断率高于美沙酮，怀孕期间丁丙诺啡使用的增加突出了有针对性的策略来支持治疗保留的必要性。

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来源期刊

Drug and alcohol review SUBSTANCE ABUSE-

CiteScore

4.80

自引率

10.50%

发文量

151

期刊介绍： Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.