Interventions for opioid use disorder during pregnancy: a scoping review

Background: Opioid use disorder during pregnancy (OUD) continues to pose a significant public health challenge, requiring well-designed interventions. This scoping review identifies effective prenatal OUD interventions to promote the use of evidence-based approaches, such as medication for opioid use disorder (MOUD), and inform future research and clinical practice. Methods: We searched PubMed, Embase, CINAHL, Scopus, and Web of Science for interventions for OUD during pregnancy from 2013 to 2023. Exclusions were non-English studies, animal research, non-prenatal interventions, pharmacological trials, and studies outside the U.S. Data were extracted on intervention context, sample, study aims, and results. We categorized each intervention by the socioecological model (SEM) level of implementation and applied the RE-AIM framework to evaluate reach, effectiveness, adoption, implementation, and maintenance. Results: After review of 1,381 articles, a total of 31 intervention studies were included. Fourteen studies (45%) included over 75% non-Hispanic white participants. Seventeen studies (55%) were conducted at the individual level, six (19%) at the interpersonal level, and eight (26%) at the society/community level. Individual-level interventions focused on coordinated clinical care models, detoxification/tapering from (MOUD), and prenatal education. Interpersonal interventions included clinician education and group therapy. Community-level interventions targeted regional coordination of services, while society level studies examined the impact of policy change on MOUD access. Conclusion: We identified a wide range of prenatal OUD interventions with varying approaches and summarized each by SEM implementation level. While MOUD access remains crucial, community-based interventions that address broader social determinants, and societal barriers may have the greatest impact in improving maternal health outcomes. Systematic Review Registration: https://osf.io/, identifier 10.17605/OSF.IO/8ZUAB.