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Biopsychosocial determinants of opioid use disorder (OUD) and implications for maternal and child health research: A scoping review

Hamisu M. Salihu, MD, PhD, Abraham Salinas, MD, PhD, Imelda Medina, MD, MPH, Janani Krishnaswami, MD, MPH, Muktar H. Aliyu, MD, DrPH


Background: Opioid use disorder (OUD) is on the rise among women of reproductive age in the United States, contributing to a marked increase in the incidence of adverse consequences on maternal and child health (MCH). There is a dearth of literature on the biopsychosocial determinants of OUD in MCH populations and their role in the current opioid epidemic. The aim of this study is to examine the epidemiology of OUD in the United States and develop a biopsychosocial research model of OUD among women of reproductive age.

Methods: Utilizing a scoping review methodology, a systematic search strategy was implemented using MEDLINE/PubMed, Integrated Library searches, and Google Scholar. Scholarly/peer-reviewed articles published up to July 2017, in English, and restricted to populations in the United States were eligible for inclusion. A qualitative synthesis of the selected studies was performed to summarize study findings.

Results: Multiple factors play a role at every level of the biopsychosocial model (BPSM) in OUD—from molecular (genetic, epigenetic), cellular-tissue, organ system, the person (psycho-affective, cognitive, and behavioral), to relationship-based (family, peers), community environment, healthcare-related, and policy levels.

Conclusion: Important research gaps persist at every level and highlight the need for multiple-level biopsychosocial research to enhance our understanding of the nature, extent, distribution, etiology, and consequences of OUD among women of reproductive age. Our biopsychosocial model of OUD can be used to guide innovative MCH epidemiology research.


Opioids, women, maternal and child health, biopsychosocial model, United States

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