Dr Duong (Danielle) Tran and her team at the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney lead multi-national studies investigating the use and safety of prescription medicines in the pregnant population. Their latest publications focus on the engagement of various populations in OAT during and after their pregnancy in New South Wales (NSW).
Pregnancy and the first year after birth are especially important periods for the health and wellbeing of both women* and their babies. For women who are dependent on opioids, treatment with methadone or buprenorphine - known as opioid agonist treatment (OAT) - is the recommended care during pregnancy and after birth. In fact, treatment with methadone or buprenorphine is safer than no treatment and should be prioritised.
Staying on OAT during this time is beneficial and can help prevent a return to illicit opioid use and reduce the risk of overdose. It also supports access to antenatal and postnatal care, promotes healthy child development, and provides stability during a period of major life change.
Researchers from NDARC’s Medicines in Pregnancy team conducted a series of studies, among the first of their kind, focusing on women in NSW who received OAT during and after pregnancy. Their analysis linked health records from NSW spanning two decades, drawing on pregnancy records, OAT prescription data, hospital admissions, and other health service information. Their study included all women who gave birth in NSW between 2004 and 2021.
The findings were largely reassuring that most women who would benefit from OAT were receiving it during pregnancy and a majority of women remained engaged in treatment throughout pregnancy and in the year after giving birth. Details as follows:
· Among women with a history of OAT, three in four received treatment during pregnancy.
· Of those, around eight in ten women stayed in treatment throughout their pregnancy and for at least a year after giving birth.
However, certain groups of women were more likely to discontinue treatment and these need further social and health care support to stay engaged. These groups include:
· Those who first started OAT after becoming pregnant
· Women receiving buprenorphine
· Women who had started treatment in prison and
· Women with mental health conditions.
Overall, these findings paint a reassuring picture of strong treatment engagement, while also identifying the groups who may benefit most from additional support to help them stay in care.
Details of each study:
In their first study, Medicines in Pregnancy focused on women with a history of OAT use in the four years prior to birth and examined how many received OAT during pregnancy and what type.
In their second study, the team focused on women who were on OAT during pregnancy and examined how many remained on treatment through to childbirth.
In their third study, they followed 3,393 women who were receiving OAT at the time of birth and examined how many continued treatment in the year after delivery.
*Please note that use of terms like ‘woman’, ‘mother’, and ‘maternal’ in this webpage refers to the biological sex, which was the focus of the studies. The information provided here should be considered inclusive of individuals who are pregnant or who have given birth but may not identify as women.
