Substance Use in Pregnancy - Optimizing Retention in Treatment

Substance use during pregnancy is a leading cause of maternal morbidity and mortality in the United States, with 55-80% of postpartum patients disengaging from substance use disorder (SUD) treatment within one year of delivery. Structural and social determinants of health, including housing instability, transportation barriers, and limited childcare access, further exacerbate disparities in treatment retention. This pilot study, conducted in two specialized prenatal care clinics, evaluates the feasibility and acceptability of two integrated strategies to promote sustained engagement in recovery-oriented services during the perinatal and postpartum periods. Aim 1 implements a standardized social needs screening and referral protocol to connect patients with community-based supports. Aim 2 pilots a contingency management intervention to incentivize recovery-supportive behaviors. Findings will inform the design of a larger multi-site randomized controlled trial to evaluate the impact of these interventions on treatment retention, overdose prevention, and maternal-infant health outcomes.

NCT Number	NCT07104123
Lead Sponsor	Washington University School of Medicine Collaborators: National Institute on Drug Abuse (NIDA)
Conditions	Substance Use Disorder (SUD), Pregnancy, Postpartum, Contingency Management
Enrollment	40 participants
Start Date	2026-02-02
Primary Completion	2026-09-01 (estimated)
Study Completion	2027-09 (estimated)
Updated on ClinicalTrials.gov	2026-08-10