MAT-LINK: MATernaL and Infant NetworK to Understand Outcomes Associated with Medication for Opioid Use Disorder during Pregnancy

MAT-LINK is a surveillance system to monitor maternal, infant, and child health outcomes associated with medication for opioid use disorder during pregnancy.

Background

Opioid use during pregnancy increases the risk of neonatal abstinence syndrome (NAS). Recent evidence suggests that children born with NAS may be at increased risk for developmental delays.¹,²
Opioid use during pregnancy has also been associated with other adverse health effects, including poor fetal growth, preterm birth, stillbirth, and specific birth defects.³
Health outcomes, including long-term outcomes, have not been systematically studied for children with prenatal opioid exposure.
Through funding from the Assistant Secretary for Planning and Evaluation’s Patient-Centered Outcomes Research Trust Fund, CDC’s National Center on Birth Defects and Developmental Disabilities established MAT-LINK.

MAT-LINK Goals

Improve understanding of the range of maternal, infant, and child health outcomes through six years of age associated with medication for opioid use disorder during pregnancy.
Examine the possible effects of exposure to multiple substances and other risk factors on maternal and infant outcomes.

Example Information in MAT-LINK

Pregnancy Exposure

Opioid use disorder
Use of other substances
Medication for opioid use disorder
Mental health conditions
Chronic medical conditions
Medications

Maternal Outcomes

Pregnancy complications
Delivery complications
Hospital length of stay

Perinatal Outcomes

Preterm birth
Small for gestational age/low birthweight
Neonatal complications (including neonatal abstinence syndrome)

Infant and Child Outcomes

Cognitive development
Language/communication development
Motor development
Social/emotional development
Growth

How These Data Are Collected and Used

Data on maternal, infant, and child health outcomes associated with medication for opioid use disorder during pregnancy are being collected across seven clinical sites: Boston Medical Center Corporation, Kaiser Foundation Research Institute (Center for Health Research-Northwest), The Ohio State University, University of New Mexico, University of Rochester, University of South Florida, and University of Utah.
Results from MAT-LINK will be used to inform clinical practice recommendations and clinical decision-making around medication for opioid use disorder among pregnant people.
In addition, this project will develop and pilot a data platform to collect and link maternal, infant, and child data across clinical sites. This can serve as a model for collecting data on other exposures during pregnancy.

Opportunities for the Future

An evaluation of MAT-LINK was done in 2021 to look at the system’s timeliness, flexibility, acceptability, data quality, and interoperability. This work will help improve the performance of the system in the years ahead.

MAT-LINK Partners

MAT-LINK Partners Group

The MAT-LINK Partners Group includes clinical and public health organizations, as well as federal agencies that have an interest in maternal and child health, child development, substance use, and public health. Examples of partner activities include sharing perspectives and priorities and disseminating project results and lessons learned to partner organizations’ membership and stakeholders. MAT-LINK partner organizations are listed below.

Clinical & Public Health Organization Partners

American Academy of Pediatrics | American College of Obstetricians and Gynecologists | Association of Maternal and Child Health Programs | Association of Public Health Laboratories | Association of State and Territorial Health Officials | National Association of County and City Health Officials | FASD United (formerly NOFAS)

Federal Agency Partners

Administration for Children and Families | Centers for Medicare and Medicaid Services | Food and Drug Administration | Health Resources and Services Administration | National Institutes of Health/National Institute on Drug Abuse | Office of the Assistant Secretary for Health | Office of the National Coordinator for Health Information Technology | Substance Abuse and Mental Health Services Administration

Learn More

For additional information on CDC’s opioid activities related to pregnancy, please visit the Opioid Use During Pregnancy webpage.
Read a summary of the project at the Office of the Assistant Secretary for Planning and Evaluation (ASPE) website.
Learn more about MAT-LINK from the following resources from ASPE’s PCOR-TF:
- “Maternal Health Consortium” webinar recording and slides featuring three PCOR-TF projects that are part of a consortium focused on using electronic health records for maternal health research, including MAT-LINK
- ASPE Annual Report: “Building the Data Capacity for Patient-Centered Outcomes Research” providing a summary of the 31 PCOR-TF projects active in FY 2020, including MAT-LINK, available as the full report or an executive summary
- Vignettes providing examples of how a range of PCOR-TF projects, including MAT-LINK, are working to improve maternal health
- MAT-LINK Phase I Final Report, published by ASPE
- ASPE/PCOR-TF report, Understanding the Impacts of OS-PCORTF Projects on Data Capacity: An Interim Qualitative Assessment, describes how projects from various agencies, including MAT-LINK, improve data quality and comprehensiveness, enhance resources, and improve data access.

Polysubstance Use in Pregnancy: Surveillance, Interventions, and Next Steps
Journal of Women’s Health 2023; DOI: 10.1089/jwh.2023.0341
Park Y, Dang EP, Board A, Gilboa SM, Ondersma SJ, Smid MC, Shakib JH, Mitchell KT, England LJ, Broussard CS, Meaney-Delman D, Iskander J, Kim SY.
[Read Summary]

Medication for Opioid Use Disorder During Pregnancy—Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014–2021
Morbidity and Mortality Weekly Report Surveillance Summaries 2023;72(No.SS-3):1–14. DOI: http://dx.doi.org/10.15585/mmwr.ss7203a1
Miele K, Kim SY, Jones R, Rembert JH, Wachman EM, Shrestha H, Henninger ML, Kimes TM, Schneider PD, Sivaloganathan V, Sward KA, Deshmukh VG, Sanjuan PM, Maxwell JR, Seligman NS, Caveglia S, Louis JM, Wright T, Bennett CC, Green C, George N, Gosdin L, Tran EL, Meaney-Delman D, Gilboa SM.
[Read Article]

The MATernaL and Infant NetworK to Understand Outcomes Associated with Treatment of Opioid Use Disorder During Pregnancy (MAT-LINK): Surveillance Opportunity
Journal of Women’s Health 2020; 29(12): 1491–1499
Tran EL, Kim SY, England LJ, Green C, Dang EP, Broussard CS, Fehrenbach N, Hudson A, Yowe-Conley T, Gilboa SM, Meaney-Delman D.
[Read Summary]

¹ Fill MA, Miller AM, Wilkinson RH, Warren MD, Dunn JR, Schaffner W, et al. Educational disabilities among children born with neonatal abstinence syndrome. Pediatrics. 2018:124(3). | ² Oei JL, Melhuish E, Uebel H, Azzam N, Breen C, Burns L, et al. Neonatal abstinence syndrome and high school performance. Pediatrics. 2017:139(2). |
³ https://www.cdc.gov/pregnancy/opioids/basics.html