The rate of pregnant women with opioid use disorder, or OUD, when giving birth more than quadrupled from 1999 to 2014, according to the Centers for Disease Control and Prevention. This indicates a significant public health concern related to adverse health outcomes for both mother and child. Impacts may range from preterm labor or neonatal abstinence syndrome, to adverse child welfare outcomes and early foster care placement.
n response to this growing concern, Oregon-based health care organizations and substance treatment centers collaborated in 2014 to develop Project Nurture, a novel intervention model that combines maternity care, substance use treatment and social services coordination for women who struggle with addiction.
A new study published in the April issue of the journal Health Affairs says that, since its inception, Project Nurture has helped to reduce the necessary placement of children in foster care by more than 8 percentage points. The rate of reported maltreatment within the child's first year of life also declined by approximately 7 percentage points.
"These outcomes are significant," says the study's lead investigator John McConnell, Ph.D., director of the Oregon Health & Science University Center for Health Systems Effectiveness. "They point to Project Nurture's positive outcomes for mothers and children as well its potential to reduce the burden on the foster care system."
McConnell and a team of researchers at OHSU, Kaiser Permanente Northwest and Portland's Central City Concern evaluated more than 1,500 Medicaid enrollees across the state of Oregon who had hospital births and concurrent OUD diagnoses between the years 2012 - 2017, comparing outcomes for women giving birth in the county served by Project Nurture to outcomes for similar women in Oregon counties not served by Project Nurture.
In addition to the positive outcomes related to child welfare, the analysis suggests that Project Nurture also helped increase the number of prenatal visits, as well as hospital length-of-stay, for new mothers diagnosed with OUD.
"The effectiveness of Project Nurture is promising; however, additional challenges such as long-term financing, secure data sharing and expanded treatment options for a broader set of substance abuse disorders must be met in order to ensure the program maintains its success and influence in integrating health care and human services in the years ahead," says McConnell.