(122) Association between partner factors on continued substance use among pregnant people with opioid use disorder

Objective: To explore associations between intimate partner factors and continued substance use among pregnant people with opioid use disorder (OUD).

Study Design: This is a multi-center prospective cohort study of pregnant people with OUD. We recruited participants >20 weeks’ gestation from four clinics specializing in perinatal addiction. We collected data at baseline and at follow-up three months later. At baseline, we collected participant demographics and intimate partner factors including substance use. Intimate partner violence (IPV) was assessed using the validated HARK (humiliation, afraid, rape, kick) questionnaire plus a financial abuse question. We defined continued use as maternal unexpected urine toxicology results at follow-up. We compared participant and partner characteristics between those with and without continued use using chi-square and Fisher’s exact test. Multivariable logistic regression was used to explore associations of partner factors with continued use while adjusting for potential confounders.

Results: Eighty participants were enrolled at four sites and 62 (77.5%) completed 3-month follow up. At baseline, 37% of participants (n=22/74 with available urine sample) had unexpected use compared to 32.3% (n=20/62) at follow-up. At baseline, 30% of participants (n=22/73) reported that their partner used substances and 64% (n=50/78) reported partner used alcohol. Many participants (36%, n=29/80) reported IPV at baseline (humiliation 29%, afraid 22%, sexual assault 10%, physical assault 17%, financial 31%). In the adjusted model, participant substance use at baseline (aOR 11.6, 95% CI 2.21, 62.2) and 3-month medication for opioid use disorder (aOR 0.03 95% CI 0.01-1) were associated with continued use at follow-up (Table). Partner factors were not significantly associated with continued use.

Conclusion: While limited by small sample size and attrition, this study found that partner factors were not associated with continued use. However, IPV was frequent and systemic screening for financial abuse should be considered in this population.