Treatment of opioid use disorder in pregnant women via telemedicine: A nonrandomized controlled trial


Guille C, Simpson A, and Douglas E, et al. (2020). Treatment of opioid use disorder in pregnant women via telemedicine a nonrandomized controlled trial. JAMA Network Open. 3(1): e1920177-e1920177. doi: 10.1001/jamanetworkopen.2019.20177.

Researchers recruited 98 pregnant women with opioid use disorder (OUD) from 4 outpatient obstetric practices in a South Carolina reproductive health database to participate in a 15-month prospective, nonrandomized controlled trial that compared maternal and newborn health outcomes between women who received obstetric OUD treatment via telemedicine (n = 44) and women who received in-person OUD treatment (n = 54) in the perinatal–postpartum period. Significant group differences included percent of women in committed relationships (telemedicine: 76.1%, in-person: 53.6%) and percent of women who received benzodiazepine prescriptions (telemedicine: 10.87%, in-person: 32.14%) despite similar rates of anxiety disorder diagnoses in the 2 groups. Participants met or videoconferenced with an obstetrician weekly (month 1), biweekly (month 2), and monthly thereafter. All participants received relapse-prevention therapy and buprenorphine. Results included retention in treatment (pregnancy through 6-8-weeks postpartum) (telemedicine: 80.4%, in-person: 92.7%), positive urine drug screen results at 6-8-weeks postpartum (telemedicine: 8.9%, in-person: 20.8%), newborns with neonatal abstinence syndrome (telemedicine: 45.4%, in-person: 63.2%), and length of newborn hospitalization (telemedicine: 9.1 days, in-person: 8.4 days). After researchers accounted for group size and controlled for committed relationships and benzodiazepine treatment, analysis of study data revealed no significant group differences in maternal and newborn health outcomes between the telemedicine and in-person cohorts. Outcomes suggest that obstetric OUD treatment via telemedicine may offer care comparable in efficacy to that of in-person treatment. Larger, randomized trials may further determine whether telemedicine facilitates effective obstetric OUD treatment and can improve access to care for pregnant women in rural areas.