# Availability, accessibility, and structure of opioid use disorder treatment and maternal and child health outcomes

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $153,357

## Abstract

The prevalence of opioid use disorder (OUD) during pregnancy has more than doubled in the past decade, as
has maternal and neonatal morbidity and mortality related to OUD. Since the beginning of the opioid epidemic,
maternal deaths attributable to drug overdose have increased by nearly 5-fold. In 2012, one infant, on average,
was born every 30 minutes in the United States with neonatal abstinence syndrome (NAS), which has
accounted for an estimated $1.5 billion in healthcare expenditures. In clinical trials, medication-assisted
treatment (MAT) use during pregnancy has been associated with reductions in adverse maternal and neonatal
outcomes. Despite this, many women with OUD do not receive treatment during pregnancy and the majority
discontinue treatment in the postpartum period. Therefore, the goal of this R01 proposal is to understand how
three different modifiable components of the delivery of OUD treatment services (i.e. availability, accessibility
and structure) differentially impact maternal and child health outcomes. To accomplish this goal, we will utilize
administrative healthcare data including claims, encounters, and pharmacy data for all Medicaid beneficiaries
in Pennsylvania including >13,000 pregnant women with OUD and their infants, from 2008 to 2017. Data will
be merged with birth certificate and early intervention data to determine if improvements in maternal OUD
treatment engagement impact pediatric health outcomes. We will create patient-level measures of OUD
treatment availability (geographic proximity to Medicaid OUD treatment providers), accessibility (duration of
Medicaid enrollment) and treatment structure (guideline concordance). The primary research aims are to 1)
assess the impact of OUD treatment availability during pregnancy (geographic proximity to Medicaid OUD
treatment providers) on maternal MAT use and birth and neonatal health outcomes; 2) assess the impact of
OUD treatment accessibility (duration of maternal Medicaid enrollment) on MAT use during pregnancy and
postpartum and pediatric health outcomes; 3) determine if the relationships between MAT use and maternal
and child health outcomes are mediated by OUD treatment structure (concordance with OUD treatment
guidelines in pregnancy). Deeply affected by the opioid epidemic, Pennsylvania has the fourth-largest Medicaid
program, rural and urban populations and demographic and socioeconomic profiles consistent with national
averages which will provide highly generalizable findings. Aim 1 will quantify the minimum geographic proximity
to Medicaid OUD treatment providers necessary to improve MAT use during pregnancy and subsequent birth
outcomes. Aim 2 will determine the relevance of pre-pregnancy and postpartum Medicaid enrollment to first
trimester MAT use and pediatric health outcomes for the first three years, which will inform Medicaid
enrollment criteria. Aim 3 will quantify the extent to which recommended components of OUD treatment
structure, beyond MAT use, ...

## Key facts

- **NIH application ID:** 10150397
- **Project number:** 3R01DA045675-03S1
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Marian Patricia Jarlenski
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $153,357
- **Award type:** 3
- **Project period:** 2018-09-30 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10150397

## Citation

> US National Institutes of Health, RePORTER application 10150397, Availability, accessibility, and structure of opioid use disorder treatment and maternal and child health outcomes (3R01DA045675-03S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10150397. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*