Evidence map›Paper›PMID 40848174›Full record

ArticleAlcohol, clinical & experimental research2025

Discontinuation of treatment for alcohol use disorder during pregnancy and postpartum in the United States.

Caitlin E Martin, Jennifer K Bello, Bridget M Galati, Joanna L Buss, Mishka Terplan, Hendrée E Jones, Kathleen T Mitchell, Silvia S Martins, Richard A Grucza, Elizabeth A Suarez and 1 more

Abstract read
In one paragraph

Article in Alcohol, clinical & experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Caitlin E MartinDepartment of Obstetrics and Gynecology and the VCU Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.ORCID 0000-0001-5560-458X
Jennifer K BelloDepartment of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
Bridget M GalatiDepartment of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
Joanna L BussInstitute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA.
Mishka TerplanFriends Research Institute, Baltimore, Maryland, USA.
Hendrée E JonesDepartment of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Kathleen T MitchellFASD United, Washington, DC, USA.
Silvia S MartinsDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.
Richard A GruczaDepartment of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
Elizabeth A SuarezCenter for Pharmacoepidemiology and Treatment Science, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, USA.
Kevin Y XuDepartment of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.ORCID 0000-0001-6595-695X

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
PHARMacist and Community Health Support to Optimize Medications After Trauma Surgery (PHARM-C)P50MH122351 · NIMH · WASHINGTON UNIVERSITY · PI Eric J Lenze · 2021 to 2026
$10.8M
Washington University Career Development Program in Drug Abuse and AddictionK12DA041449 · NIDA · WASHINGTON UNIVERSITY · PI Laura J. Bierut, Patricia A Cavazos-Rehg · 2017 to 2026
$4.2M
A Preconception Health Intervention to Reduce Substance Exposed Pregnancies among Incarcerated WomenK23DA053433 · NIDA · SAINT LOUIS UNIVERSITY · PI Jennifer Bello Kottenstette · 2022 to 2026
$873k
Using Big Data to Optimize Treatment of Opioid Use Disorder in PregnancyK08DA061258 · NIDA · WASHINGTON UNIVERSITY · PI Kevin Young Xu · 2024 to 2026
$664k
NCATS NIH HHS UL1 TR002345NIDA NIH HHS K08 DA061258NIDA NIH HHS K12 DA041449NIDA NIH HHS K23 DA053433NIH HHS K12 DA041449NIH HHS K23DA053433NIH HHS NIH K08DA061258NIH HHS P50 MH122351NIMH NIH HHS P50 MH122351Saint Louis UniversityWashington University in St. Louis
6 · The paper itself

Abstract

backgroundThe degree of alcohol use disorder (AUD) treatment utilization during the perinatal period is unknown. We report the prevalence of preconception receipt of medications for AUD (MAUD) and psychosocial interventions (PSY), discontinuation during pregnancy, and postpartum resumption in a multi-state sample, comparing pregnant and nonpregnant people with AUD.

methodsUsing MarketScan combined commercial and Medicaid claims (2016-2019), we identified individuals with AUD who had continuous insurance coverage throughout pregnancy, classifying those with a live birth as pregnant, and compared their MAUD and PSY patterns to nonpregnant peers matched by age, insurance type, and calendar time. All individuals had ≥1 claim for: (a) AUD diagnosis and (b) MAUD or PSY in the year preceding the study. Outcomes-filled MAUD prescriptions (naltrexone, acamprosate, and disulfiram) and receipt of PSY-were identified via claims. We computed rates of MAUD and PSY receipt, stratifying by five observation windows for pregnant individuals (12-week preconception; first, second, and third trimesters; 12 weeks postpartum) and nonpregnant peers (by corresponding windows). We assessed time to treatment discontinuation using multivariable Cox regression, adjusting for sociodemographics and comorbidities.

resultsOur sample consisted of 2080 pregnant persons with AUD and 7564 matched nonpregnant AUD peers. During pregnancy, MAUD receipt declined from 12.1% (preconception) to 0.3% (third trimester) among pregnant people and from 13.5% to 8.1% in nonpregnant peers during the equivalent time period (p < 0.001). Postpartum resumption of MAUD was uncommon in the pregnant cohort (pregnant = 1.9%; nonpregnant = 7.8%, p < 0.001). PSY declined for both the pregnant and nonpregnant cohorts yet remained modestly higher in the nonpregnant cohort (postpartum 10.3% vs. 13.8%, p < 0.001). In adjusted analyses, pregnant people were more likely to discontinue MAUD than nonpregnant peers (HR = 2.11 [1.71-2.60]) yet not more likely to discontinue PSY (HR = 1.01 [0.87-1.17]).

conclusionsAmong pregnant people with preconception AUD receiving treatment, MAUD utilization is low and discontinuation is widespread, persisting postpartum.

Indexed as

AlcoholismPostpartum PeriodPregnancy ComplicationsWithholding TreatmentAcamprosateAdultAlcohol DeterrentsDisulfiramFemaleHumansNaltrexonePregnancyUnited StatesYoung AdultAcamprosateAlcohol DeterrentsDisulfiramNaltrexoneacamprosateadministrative claimsalcohol use disorderdisulfiraminsurancenaltrexonepregnancy

Identifiers

PMID40848174
PMCPMC12380126

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.