Challenges for Antepartum Care of the Individual with Perinatal Substance Use: An Empirical Integrative Review of Novel Approaches to Improve Care.

It is a review of 10 heterogeneous studies, not a single trial, so it cannot show how much any one component helped. Many included studies were small, including fewer than 50 participants, which limits generalizability. Several studies did not meet quality appraisal criteria, and many did not account for confounders. The search used only 2 databases, only the last 5 years, only English, and only United States studies. Most included studies were qualitative, quality improvement, pilot, or retrospective descriptive work rather than randomized trials. Integrated models often combined obstetric care, substance use treatment, behavioral health, social services, and peer support at once, so the contribution of any single component cannot be separated.

The authors reported no conflicts of interest.

Do not read these models as proven to improve maternal or infant outcomes. The review included small, nonrandomized studies, and several models combined screening, treatment, behavioral health, social services, and peer support at once, so the contribution of any single component cannot be separated.