(365) Antepartum Multidisciplinary Approach Improves Postpartum Pain Scores in Patients with Opioid Use Disorder

Pregnancies affected by maternal opioid use disorder (MOUD) face difficulties with postpartum pain control and Neonatal Opioid Withdrawal Syndrome (NOWS). This study aims to determine if prenatal anesthesia consultation for MOUD patients affects maternal and fetal outcomes.

Study Design: This is a retrospective cohort study of pregnant patients diagnosed with MOUD who received prenatal care and delivered at an academic institution between January 2017 and July 2023. Subjects were divided into those who received prenatal anesthesia consultation and those who did not. Severe pain on a numerical rating scale was defined as score >7. Statistical analysis was performed using Mann-Whitney U test with statistical significance defined as p< 0.05.

Results: The cohort included 324 women with MOUD. Of these, 15.7% (N=51) received anesthesia consultation and 84.3% (N=273) did not. When comparing pain scores in the first 24 hours postpartum, patients with prenatal anesthesia consultation had statistically significant lower rates of severe pain compared to those who did not (26% vs. 45.3%, p=0.01). Neonatal outcomes were assessed; though NOWS diagnoses were not associated with prenatal anesthesia consultation, NICU admissions were significantly fewer for patients who had anesthesia referral (p=0.01). Factors found to have significant association with prenatal anesthesia consultation were care with an obstetric provider with training in maternal opioid care (p< 0.01) and a higher number of prenatal care visits (10.3 vs. 8.9, p=0.02).

Conclusion: MOUD patients who received anesthesia consultation in pregnancy reported lower postpartum pain scores than those without consultation. Our data supports multidisciplinary care including prenatal anesthesia consultation for MOUD patients.