Surveillance Network: Maternal, Infant, and Child Health Outcomes Following Treatment of Opioid Use Disorder (OUD) During Pregnancy

Establish a Surveillance Network across Multiple Clinical Sites to Rapidly Collect Data and Monitor Maternal, Infant, and Child Health Outcomes Related to Treatment for OUD During Pregnancy
Agency
  • Centers for Disease Control and Prevention (CDC)
Start Date
  • 3/4/2019
Functionality
  • Standardized Collection of Standardized Clinical Data

 

STATUS: Active Project

BACKGROUND

From 1999-2014, the prevalence of opioid use disorder (OUD) among pregnant women in the United States quadrupled from 1.5 to 6.5 per 1,000 delivery hospitalizations. Opioid use during pregnancy increases the risk of an infant being born with neonatal abstinence syndrome (NAS). Recent evidence suggests that children who are born with NAS may experience developmental delays, however, the developmental trajectory of these children has not been systematically studied.

The American College of Obstetricians and Gynecologists recommends that pregnant women with OUD be offered an opioid agonist (methadone, buprenorphine) to treat OUD during pregnancy. In some clinical settings, pregnant women may also be offered medically supervised withdrawal (opioid detoxification). There is limited information, however, comparing maternal, infant, and child health outcomes associated with these treatment regimens during pregnancy.

In 2016, CDC established a surveillance system to monitor pregnant women with laboratory evidence of Zika virus infection and their infants called the US Zika Pregnancy and Infant Registry (USZPIR). This system captures timely data, which are used to inform clinical and public health practice recommendations. The lessons learned and tools used to establish the USZPIR will be adapted and leveraged for the Maternal and Infant Network (MAT-LINK), a surveillance system to monitor the maternal, infant, and child health outcomes following treatment for OUD during pregnancy.

The results from MAT-LINK will be used to improve our understanding of the spectrum of maternal, infant, and child health outcomes following treatment for OUD during pregnancy and the role of mediating and moderating factors on maternal and infant outcomes, including exposure to multiple substances, maternal comorbidities, and other psychosocial factors, as well as to improve policies, clinical practice recommendations, and clinical decision-making. In addition, this project will also develop and pilot a data platform to collect and link maternal, infant, and child data across clinical sites, and which can be modified to collect linked data on other exposures during pregnancy.

PROJECT PURPOSE & GOALS

MAT-LINK will establish a surveillance network, consisting of 3-5 clinical sites, to collect data on maternal, infant, and child health outcomes associated with treatments for OUD during pregnancy. The overall objectives of the project are to

  • Establish an organizational structure, which would include federal agency representatives, clinical and public health partners, and the CDC steering committee, to provide critical input on linked maternal and infant health data collection approaches and analytical priorities; and
  • Develop a data platform to collect linked maternal and infant data among women treated for OUD during pregnancy.
  • Analyze and disseminate preliminary results to inform patient-centered care for pregnant women with OUD and for infants and children with prenatal opioid exposure.