The health impact of intensive case management on women with OUD and their infants

Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this study was to evaluate program outcomes of postpartum women with OUD and the health outcomes of their infants when engaged in an intensive case management program postpartum. The study was a retrospective review of secondary data collected on 221 postpartum mothers and 225 infants of mothers who were enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine timing of engagement during pregnancy, maternal treatment outcomes and infant health outcomes including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. At the time of data collection, of the 221 mothers in the study, 45.2% (n = 100) were identified as engaged, 14.5% (n = 35) were identified as graduated, and of the mothers who graduated, 78.1% (n = 25) were noted as engaged in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 1.20); mean gestational age was 38.3 weeks (SD = 1.80) and mean length of stay was 8.19 days (SD = 9.8). The findings of this study identified that engaging mother during pregnancy in a program designed to meet their unique challenges positively impact both the mother and infant outcomes, regardless of the timing during pregnancy