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Characteristics and quality of life of opioid-dependent pregnant women in Austria

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Abstract

This study investigated pregnant opioid-dependent women undergoing maintenance therapy, applying a multidisciplinary, case-management approach at the Addiction Clinic of the Medical University of Vienna, Austria. It aimed at characterizing the patients’ basic demographic and clinical parameters and evaluating their overall quality of life (QoL) prepartum and postpartum. Three hundred ninety women were treated between 1994 and 2009 with buprenorphine (n = 77), methadone (n = 184), or slow-release oral morphine (SROM) (n = 129) on an outpatient basis throughout their pregnancy and postpartum period. All patients were subject to standardized prepartum and postpartum medical and psychiatric assessments, including QoL assessments using a German adaptation of the Lancashire QoL Profile (Berliner Lebensqualitaetsprofil), and regular supervised urine toxicologies. No medication group differences were revealed regarding basic demographic or clinical data. Mean maintenance doses (SD) at time of delivery were as follows: 64 mg (36 mg) methadone, 10 mg (6 mg) buprenorphine, 455 mg (207 mg) SROM. However, buprenorphine-medicated women showed significantly less concomitant benzodiazepine consumption than methadone- or SROM-maintained women (p = 0.005), and significantly less concomitant opioid consumption than methadone-maintained women (p = 0.033) during the last trimester. Overall QoL was good prepartum and postpartum in all measured domains except “finances” and “prospect of staying in the same housing situation,” and no differences were observed in QoL among the three medication groups (p = 0.177). QoL improved significantly after delivery in most of the domains (p < 0.001). Although opioid-dependent pregnant women face high-risk pregnancies and show variability in addiction severity, they report good QoL independent of the medication administered. These results show that individually tailored treatment interventions are effective for this patient population and suggest a QoL improvement after delivery.

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Acknowledgments

The authors would like to thank the staff involved in the treatment of the women at the cooperating Departments at the Medical University of Vienna, Austria, as well as in other hospitals in the area. Moreover, we would like to thank the administrative staff and all colleagues helping with data compilation, and of course the Austrian National Bank (project no. 13637) and NIDA (R01DA018417), whose funds were used for payment of staff involved in the project. In addition, financial support for the preparation of this manuscript was provided to Dr. Comer by the National Institute on Drug Abuse grant DA09236. We would like to thank the patients for their compliance and willingness to have their data analyzed for research purposes.

Conflict of interest

Over the past 3 years, SDC received compensation (in the form of partial salary support) from investigator-initiated studies supported by Reckitt Benckiser Pharmaceuticals, Schering-Plough Corporation, Johnson & Johnson Pharmaceutical Research & Development, Endo Pharmaceuticals, and MediciNova. In addition, SDC served as a consultant to the following companies: Grunenthal USA, Guidepoint Global, Mallinckrodt, Neuromed, Orexo, Pfizer, and Salix. GF received buprenorphine for her research (R01DA018417) from Reckitt Benckiser, as well as travel support to present data at conferences from Mundipharma, Reckitt Benckiser, Lannacher (GL Pharma), Roche, and Schering Plough.

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Authors and Affiliations

  1. Department of Psychiatry, Columbia University and NYSPI, 1051 Riverside Drive, Unit 120, New York, NY, 10032, USA

    Verena E. Metz & Sandra D. Comer

  2. Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria

    Verena E. Metz, Johanna Wuerzl, Anna Pribasnig & Gabriele Fischer

  3. Center for Public Health, Medical University of Vienna, Vienna, Austria

    Gabriele Fischer

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  1. Verena E. Metz
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Correspondence to Verena E. Metz.

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Metz, V.E., Comer, S.D., Wuerzl, J. et al. Characteristics and quality of life of opioid-dependent pregnant women in Austria. Arch Womens Ment Health 17, 529–539 (2014). https://doi.org/10.1007/s00737-014-0443-6

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