College of MedicineCollege of MedicineAboutDepartments & UnitsCommunity and Behavioral HealthResearchPerinatal Substance Use and Maternal-Infant Health

Perinatal Substance Use and Maternal-Infant Health

Substance use during pregnancy and the postpartum period affects a growing number of families across Washington State and the nation and presents complex public health challenges for families, infants, healthcare providers, and care systems. Infants exposed to opioids in utero may develop Neonatal Abstinence Syndrome (NAS)/Neonatal Opioid Withdrawal (NOWS), a group of withdrawal symptoms in infants that can include difficulty feeding and sleeping, irritability, and trouble being soothed. At the same time, pregnant and postpartum individuals with substance disorders often face stigma, fragmented services, and significant barriers to treatment and supportive care. Improving outcomes for families impacted by substance use requires not only effective treatment for infants and parents, but also better caregiving support, provider training, and systems of care that facilitate comprehensive support for families.

Ekaterina Burduli’s, PhD, research focuses on improving outcomes for women and families affected by opioid use disorder and other substance use during the perinatal period, with particular emphasis on neonatal abstinence syndrome/neonatal opioid withdrawal syndrome, intervention development, stigma, and access to evidence-based care. Her current and recent projects include the development and testing of mobile education tools for pregnant women with opioid use disorder, evaluation of pediatric transitional care models for substance-exposed newborns and their caregivers, studies of early developmental outcomes among infants prenatally exposed to fentanyl and other substances, and implementation-focused work to expand provider capacity for perinatal substance use care.

Current research in this area is focused on:

  1. Understanding the impact of prenatal substance exposure — including fentanyl and other opioids — on birth outcomes and on infants’ cognitive, motor, behavioral, and socioemotional development in early childhood, with the goal of identifying early risk indicators and opportunities for intervention.
  2. Developing and testing innovative, evidence-based interventions for perinatal individuals with opioid use disorder and their newborns, including a mobile caregiving education tool for NAS, and training tools to build healthcare provider competency and reduce stigma in perinatal care.
  3. Evaluating and improving systems of care for substance-exposed newborns and their families, including a statewide evaluation of a Spokane-based pediatric transitional care facility for infants with NAS, efforts to improve neurodevelopmental follow-up for high-risk newborns in rural communities, and the application of implementation science to scale and sustain effective addiction-related interventions.