Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

LARC in Women Treated for Opioid Use Disorder

Contraception; ePub 2018 Aug 13; Kotha, et al

Most pregnant women with opioid use disorder (OUD) on medication-assisted treatment (MAT) did not receive long-acting reversible contraception (LARC), despite prenatal interest in using LARC. This according to retrospective cohort study of 791 pregnant women with OUD on MAT who delivered at an academic institution without immediate postpartum LARC services between 2009 and 2012. Researchers evaluated factors associated with prenatal and postpartum receipt of LARC in this study population. They found:

  • Among 719 pregnant women with OUD on MAT, 275 (34.8%) intended to use postpartum LARC and only 237 (29.9%) attended the postpartum visit.
  • Among 275 women with prenatal LARC intent, 124 (45.1%) attended their postpartum and 50 (18.2%) received a postpartum LARC.
  • Prenatal contraceptive counseling was positively associated with LARC intent.
  • Conversely, older age and private practice provider were negatively associated with LARC intent.


Kotha A, Chen BA, Lewis L, Dunn S, Himes KP, Krans E. Prenatal intent and postpartum receipt of long-acting reversible contraception among women receiving medication-assisted treatment of opioid use disorder. [Published online ahead of print August 13, 2018]. Contraception. doi:10.1016/j.contraception.2018.08.008.

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