Poor prenatal care does not predict well child care for children born to mothers with opioid use disorder

ABSTRACT

Objectives: Among mothers receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) and their children, (1) assess characteristics associated with adequate prenatal care and well-child care, and (2) determine if prenatal care predicts well-child care and up-to-date immunizations (UTDI).

Methods: This is a retrospective study of mothers with OUD and their children, maternal sociodemographic and health characteristics, and child health characteristics. Adequate prenatal care was defined by the Kotelchuck Index, well-child care by AAP recommendations, and UTDI by the 4:3:1:3:3:1:4 series.

Results: For the 138 mother-child dyads, mothers were largely young (mean: 29 years), multiparous (73%), and receiving Medicaid (93%); only 31% had adequate prenatal care. The majority of children (67%) had adequate well-child care, and UTDI (93%). Children born to non-Hispanic mothers or with LOS > 5 days were more likely to have adequate well-child care, in contrast to those with wheezing who were less likely. In the adjusted analysis, younger children and those born to primiparous mothers were more likely to have adequate well-child care. Adequate prenatal care did not predict adequate well-child care or UTDI.

Conclusions: Despite the fact that mothers receiving MAT for OUD often lacked adequate prenatal care, their children had adequate well-child care and UTDI.

Abbreviations: AAP: American Academy of Pediatrics; aOR: Adjusted odds ratio; DTaP: Diphtheria, tetanus toxoids and acellular pertussis vaccine; GA: Gestational age; HepA: Hepatitis A vaccine; HepB: Hepatitis B vaccine; Hib: Haemophilus influenzae type b vaccine; IPV: Inactivated polio vaccine; ICN: Intensive care nursery; LOS: Length of stay; MATER: Maternal Addiction Treatment Education and Research; MAT: Medication-Assisted Treatment; MMR: Measles, mumps, and rubella vaccine; OUD: Opioid use disorder; PCV: Pneumococcal conjugate vaccine; TJU: Thomas Jefferson University; TJUH: Thomas Jefferson University Hospital; US: United States; UTDI: Up-to-date immunizations; 4:3:1:3:3:1:4: 4 DTaP:3 IPV:1 MMR:3 Hib:3 HepB:1 Varicella:4 PCV

KEYWORDS:

• Well-child care
• healthcare utilization
• opioid use
• prenatal care

Acknowledgments

We would like to thank the families who seek care at Thomas Jefferson University Hospital and bring their children to NdPP for their pediatric care. We are grateful for the hard-working clinicians providing healthcare and support to families affected by opioid use disorder. Special thanks goes to Meghan J. Brumbley, BA and Roxanne Erolin, MPH, who assisted with chart abstraction and data entry. This work was supported in part by the Department of Health and Human Services Administration for Children and Families [Grant Award Number: 90CB0190]

Disclosure of potential conflict of interest

The authors declare no conflicts of interest.

Additional information

Funding

This work was supported in part by the US Department of Health and Human Services Administration for Children and Families under Grant number [90CB0190].