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Poster Session 4

Category: Health Equity/Community Health

Poster Session 4

(1187) Can we mitigate environmental influences on relapse patterns in pregnant persons with substance use disorder?

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Michelle R. Petrich, MD (she/her/hers)

MFM Fellow
Saint Louis University/SSM Health
Saint Louis University/St. Louis, Missouri, United States

Coauthor(s)

ES

Enbal Shacham, PhD

Saint Louis University/College for Public Health and Social Justice
Saint Louis University/St. Louis, Missouri, United States
SS

Stephen Scroggins, PhD

Saint Louis University/College for Public Health and Social Justice
Saint Louis University/St. Louis, Missouri, United States
Justine Keller, MD

Assistant Professor
Saint Louis University/SSM Health
Saint Louis University/St. Louis, Missouri, United States
Sophia Izhar, BS (she/her/hers)

Medical student
Saint Louis University/School of Medicine
Saint Louis University School/St. Louis, Missouri, United States
SJ

Sathvika Janga, BS

Medical student
Saint Louis University/School of Medicine
Saint Louis University/St. Louis, Missouri, United States
MD

Maanasa Devabhaktuni, BS

Medical student
Saint Louis University/School of Medicine
Saint Louis University/St. Louis, Missouri, United States
Niraj R. Chavan, MD, MPH (he/him/his)

Associate Professor, Program Director - MFM Fellowship, Medical Director - WISH Center, Regional OB Quality Chair - SSM Health
Saint Louis University
Saint Louis, Missouri, United States

Objective:
We sought to evaluate the impact of social vulnerability on relapse patterns among pregnant persons with substance use disorder (SUD) treated at a comprehensive perinatal SUD program with co-located obstetric, behavioral health and wrap-around psychosocial support services.

Study Design:
We conducted a retrospective cohort study of mother-infant dyads who received prenatal care at our specialized perinatal SUD center over a 10-year span from 1/2014 to 3/2023. Given social vulnerability index (SVI) has a relative value, SVI scores were recalculated, per CDC/ATSDR documentation, from raw 2022 5-Year ACS values and ranked within respective states. Demographic characteristics, substance use behavior and relapse patterns were abstracted from electronic records and compared across subgroups with and without the primary outcome–perinatal (antepartum and/or postpartum) relapse. Significant bivariate associations were determined at the a=0.05 level using chi-square test for categorical variables and Mann-Whitney U test for numeric variables.

Results:
Of 1047 pregnancies, 831 participants were geocoded across 416 census tracts traversing 2 contiguous states. 517 (49%) p</span>atients were noted to have a perinatal relapse. Participants’ SVI score within their respective census tracts is shown in Figure 1. Although prior substance use histories were similar, current behaviors differed: opioid use in conjunction with benzodiazepines (p < .001), stimulants (p=.004), and tobacco (p < .001) as well as current tobacco use (p=.002) were associated with relapse. Patients who engaged in behavioral health counseling (p=.02) and received treatment by a perinatal psychiatrist (p < .001) were less likely to have a relapse (Table 1).

Conclusion:
Although our population was exposed to varying levels of social vulnerability, our data suggest the influence of environmental stressors on relapse may be mitigated by participation in a comprehensive perinatal SUD program. Addressing determinants of social vulnerability through an integrated healthcare delivery model is critical for establishing perinatal health equity and reducing relapse.