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Clinical Obstetrics

Poster Session 2

(410) Clinical Implications of Group Residential Treatment on Pregnant Individuals with Substance Use Disorder

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Unstable housing has been associated with obstetric (OB) outcomes of increased risk of preterm birth and longer hospital stays. As clinical care for substance use disorder (SUD) may involve recovery housing, this study evaluates group residential living effects on maternal and neonatal outcomes for women with SUD.

Study Design: This was a longitudinal cohort study of OB patients with SUD within a multi-specialty treatment program from 2015 to 2023. The intervention group included patients in group housing (i.e., residential treatment, recovery housing, or sober living facilities) at time of initial prenatal visit. Outcomes including maternal trauma, medications for opioid use (MOUD), infant birth weight, APGARs, and neonatal hospital stay length were observed. Fisher’s exact and two-sample t-tests were used for analysis.

Results: Overall, 87 patients resided in group housing and 380 resided in alternative housing (controls). Age, parity, race, and BMI did not differ significantly between groups. Patients in group housing had significantly greater history of past overdose (63% vs. 42%, p=0.01), violence or trauma experience (82% vs. 69%, p < 0.05), less likelihood of private insurance (0 vs. 5%, p</span> < 0.05), higher anxiolytic use (17% vs. 9%, p < 0.05), and less satisfaction with living condition (56% vs. 66%, p < 0.05). Women in group housing reported different MOUD from those in alternative housing (p < 0.05), as they used more methadone (4.7% vs. 0.5%) or no MOUD at all (16% vs. 12%). Women in alternative housing reported more buprenorphine use (87% vs. 79%). Mean infant birth weight differed for those in group housing (3049 vs. 2926 grams, p=0.05). There were no significant differences in delivery mode or gestational age, APGARS, or neonatal length of hospital stay.

Conclusion: Despite a higher allostatic load, patients in group housing had differing infant birth weights and similar pregnancy and neonatal outcomes albeit small numbers. Further review may be valued to maximize OB outcomes and SUD treatment in this population.