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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
OS-PCORTF Strategic Plan Alignment
  • Primary: Goal 1. Data Capacity for National Health Priorities
  • Secondary: Goal 2. Data Standards and Linkages for Longitudinal Research

 

STATUS: Completed 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 comparing maternal, infant, and child health outcomes associated with these treatment regimens during pregnancy.

The MATernaL and Infant NetworK to Understand Outcomes Associated with Medication for Opioid Use Disorder during Pregnancy (MAT-LINK) can 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 developed a data platform to collect and link maternal, infant, and child data across clinical sites, and modified the collection of linked data on other exposures 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.

PURPOSE

This project aimed to establish a surveillance network to collect data on maternal, infant, and child health outcomes associated with treatments for OUD during pregnancy by:

  • Establishing an organizational structure, inclusive of federal agency representatives, clinical and public health partners, and the project’s CDC Steering Committee, to provide critical input on linked maternal and infant health data collection approaches and analytical priorities.
  • Developing a data platform, MAT-LINK, to collect linked maternal and infant data among women treated for OUD during pregnancy.
  • Analyzing and disseminating preliminary results of MAT-LINK’s development and the use of aggregated data submitted by participating MAT-LINK clinical sites to inform patient-centered care for pregnant women with OUD and infants and children with prenatal opioid exposure.

KEY IMPACTS

Addressing national priorities for health: Data to study the opioid overdose crisis
MAT-LINK is the first surveillance system to collect comprehensive, longitudinal EHR data to monitor maternal, infant, and child health outcomes associated with medications for OUD during pregnancy. The dataset includes over 2,000 linked mother-infant pairs with OUD, with child follow-up through age two. Researchers can use MAT-LINK data to study the effects of different treatments for OUD on infant and child development.

Enhancing analytic resources: Tools to address data quality issues
The project team developed tools to address data quality issues when creating the MAT-LINK platform. The team developed methods to collect manually submitted data from clinical sites and data queried from the participating clinical sites, which improved the consistent and efficient collection of data across sites. In 2022, MAT-LINK received the Information Technology award from the CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) for data pipelining, optimization, and transformation.

Publications

MAT-LINK Data and User Guide. This site includes information on how to request the restricted data and user guide.

The MATernaL and Infant NetworK to Understand Outcomes Associated with Treatment of Opioid Use Disorder During Pregnancy (MAT-LINK): Surveillance Opportunity. This publication in the Journal of Women’s Health provides a list of the core variables used in the surveillance of OUD during pregnancy and discusses how MAT-LINK addresses knowledge gaps regarding the treatment of OUD during pregnancy.

Polysubstance Use in Pregnancy: Surveillance, Interventions, and Next Steps. This publication describes the activities of the CDC/NCBDDD team to address adverse maternal and child health outcomes from polysubstance use and gaps related to surveillance, routine screening, and prevention of polysubstance use during pregnancy.

Medication for Opioid Use Disorder During Pregnancy — Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014–2021. This publication describes MAT-LINK surveillance and data methods.

Project Final Report. This final report summarizes the background, lessons learned, future considerations, and products and presentations resulting from the MAT-LINK project.