Grant: Doctoral Research Award: Canada Graduate Scholarships

Opioid use disorder (OUD) during pregnancy is associated with multiple negative maternal and fetal outcomes. Although evidence suggests that opioid agonist therapies (OAT) may result in better health outcomes for mother and infant, many pregnant women enrolled in OAT are prescribed treatments that are of insufficient dose or duration. These issues may contribute to challenges with adherence or relapse, which can have negative maternal and fetal health consequences, including heightened risk of overdose. Our research will seek to: 1) Compare pregnancy outcomes between women living with OUD who are prescribed different types of OAT or no OAT during pregnancy; 2) Evaluate factors associated with adherence to and retention in different types of OAT during pregnancy and postpartum; 3) Examine changes in risk of non-fatal and fatal overdose during pregnancy and postpartum, and whether this differs by OAT dosage and retention. We will rely on a province-wide linked retrospective cohort of people living with opioid use disorder using linked data from the BC Perinatal Data Registry, prescription dispensations, and other databases held by the Ministry of Health. We will analyse the impact of different OAT regimens on pregnancy outcomes, the role of sociodemographic, clinical, and geographic factors in adherence to different types of OAT, and changes in overdose risk during pregnancy and postpartum. These findings can be used to inform evidence-based harm reduction policies and clinical practice guidelines that will connect pregnant women with safe and effective therapies, reduce stigma around OAT for pregnant women, promote uptake of prenatal care, and result in healthier and safer pregnancies for both mother and child.