2022
Support Models for Addiction Related Treatment (SMART) for pregnant women: Study protocol of a cluster randomized trial of two treatment models for opioid use disorder in prenatal clinics
Forray A, Mele A, Byatt N, Tobon A, Gilstad-Hayden K, Hunkle K, Hong S, Lipkind H, Fiellin DA, Callaghan K, Yonkers KA. Support Models for Addiction Related Treatment (SMART) for pregnant women: Study protocol of a cluster randomized trial of two treatment models for opioid use disorder in prenatal clinics. PLOS ONE 2022, 17: e0261751. PMID: 35025898, PMCID: PMC8758001, DOI: 10.1371/journal.pone.0261751.Peer-Reviewed Original ResearchConceptsOpioid use disorderPregnant womenUse disordersPrenatal clinicsClinical trialsReproductive health cliniciansCollaborative care approachTRIAL REGISTRATION NUMBERCommunity Healthcare OutcomesMatched-pair clusterPatient treatment engagementTreatment modelObstetric providersOUD treatmentPrimary outcomeObstetrical providersPostpartum womenHealth cliniciansCare approachRegistration numberTreatment engagementRelated treatmentsHealthcare outcomesTrialsWomen
2021
Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome
Radhakrishna U, Nath SK, Vishweswaraiah S, Uppala LV, Forray A, Muvvala SB, Mishra NK, Southekal S, Guda C, Govindamangalam H, Vargas D, Gardella WG, Crist RC, Berrettini WH, Metpally RP, Bahado-Singh RO. Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome. Genomics 2021, 113: 3610-3617. PMID: 34352367, DOI: 10.1016/j.ygeno.2021.08.001.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromePrenatal opioid exposureOpioid use disorderPlacentas of infantsPlacental tissue samplesP-valueIngenuity Pathway AnalysisOpioid exposureUse disordersUnexposed controlsFDR p-valueGenes CYP1A1Tissue samplesSyndromePathway analysisCYP1A1NewbornsInfantsEtiologyApoBPlacentaGenesGRIN2AThe Collision of Mental Health, Substance Use Disorder, and Suicide
Forray A, Yonkers KA. The Collision of Mental Health, Substance Use Disorder, and Suicide. Obstetrics And Gynecology 2021, 137: 1083-1090. PMID: 33957654, DOI: 10.1097/aog.0000000000004391.Peer-Reviewed Original ResearchConceptsRisk of suicideSubstance use disordersUse disordersMental healthPerinatal periodSuicidal thoughtsReproductive health care clinicsSevere perinatal depressionHealth care clinicsCause of deathWomen's mental healthPerinatal depressionCare clinicsPerinatal womenPregnant womenDepressive episodeReproductive yearsPsychiatric illnessAmerican CollegePsychiatric disordersCareful monitoringPsychiatric conditionsSuicide attemptsChildhood adversitySuicide preventionPlacental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome
Radhakrishna U, Vishweswaraiah S, Uppala LV, Szymanska M, Macknis J, Kumar S, Saleem-Rasheed F, Aydas B, Forray A, Muvvala SB, Mishra NK, Guda C, Carey DJ, Metpally RP, Crist RC, Berrettini WH, Bahado-Singh RO. Placental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome. Genomics 2021, 113: 1127-1135. PMID: 33711455, DOI: 10.1016/j.ygeno.2021.03.006.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeIngenuity Pathway AnalysisWithdrawal syndromeOpioid-exposed pregnanciesPlacental tissue samplesOpioid abusePlacental tissueTissue samplesPregnancyMethylation dysregulationGenome-wide methylation analysisSyndromeInfantsPathway analysisAUCDNA methylation profilesMethylation profilesGroupPathophysiologyTherapyStrong evidence
2019
Opioid Use in Pregnancy
Tobon AL, Habecker E, Forray A. Opioid Use in Pregnancy. Current Psychiatry Reports 2019, 21: 118. PMID: 31734808, PMCID: PMC10296780, DOI: 10.1007/s11920-019-1110-4.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid use disorderOpioid exposureOpioid useMajor public health problemNeonatal adverse outcomesOpioid withdrawal syndromeStandard of carePublic health problemTerms of incidenceIllicit drug useSignificant adverse effectsMaintenance therapyPerinatal outcomesPregnancy outcomesRecent longitudinal studiesWithdrawal syndromeFetal effectsPregnant womenAdverse outcomesLong-term effectsUse disordersDrug useHealth problemsBrain morphology
2017
A randomized controlled trial of screening and brief interventions for substance misuse in reproductive health
Martino S, Ondersma SJ, Forray A, Olmstead TA, Gilstad-Hayden K, Howell HB, Kershaw T, Yonkers KA. A randomized controlled trial of screening and brief interventions for substance misuse in reproductive health. American Journal Of Obstetrics And Gynecology 2017, 218: 322.e1-322.e12. PMID: 29247636, PMCID: PMC6896206, DOI: 10.1016/j.ajog.2017.12.005.Peer-Reviewed Original ResearchConceptsEnhanced usual care groupPrimary substance useUsual care groupUsual careBrief interventionTreatment useSubstance useCare groupSubstance misuseReproductive health settingsEnhanced usual careTrial of screeningDays/monthMonths of useGeneralized estimation equationsCoprimary outcomesPrescription medicationsReproductive centerHealthcare centersPregnancy statusHealth settingsReferralReproductive healthMean daysCareAssociation of Panic Disorder, Generalized Anxiety Disorder, and Benzodiazepine Treatment During Pregnancy With Risk of Adverse Birth Outcomes
Yonkers KA, Gilstad-Hayden K, Forray A, Lipkind HS. Association of Panic Disorder, Generalized Anxiety Disorder, and Benzodiazepine Treatment During Pregnancy With Risk of Adverse Birth Outcomes. JAMA Psychiatry 2017, 74: 1145-1152. PMID: 28903165, PMCID: PMC5710298, DOI: 10.1001/jamapsychiatry.2017.2733.Peer-Reviewed Original ResearchConceptsSerotonin reuptake inhibitor useAdverse birth outcomesLow birth weightSerotonin reuptake inhibitorsWeeks of pregnancyHypertensive diseaseDuration of gestationRespiratory interventionsVentilatory supportCesarean deliveryReuptake inhibitorsPanic disorderPregnancy outcomesInhibitor usePreterm birthBirth outcomesBenzodiazepine treatmentBirth weightAnxiety disordersWorld Mental Health Composite International Diagnostic InterviewPrevious adverse birth outcomesComposite International Diagnostic InterviewAdverse pregnancy complicationsMaternal panic disorderNeonatal pregnancy outcomesProgesterone for smoking relapse prevention following delivery: A pilot, randomized, double-blind study
Forray A, Gilstad-Hayden K, Suppies C, Bogen D, Sofuoglu M, Yonkers KA. Progesterone for smoking relapse prevention following delivery: A pilot, randomized, double-blind study. Psychoneuroendocrinology 2017, 86: 96-103. PMID: 28926762, PMCID: PMC5659923, DOI: 10.1016/j.psyneuen.2017.09.012.Peer-Reviewed Original ResearchConceptsPre-pregnancy smokingSmoking levelsWeek 8Progesterone levelsPlacebo-controlled pilot trialDouble-blind studyOral micronized progesteroneSerious adverse eventsWeeks of gestationMain outcome measuresHalf of womenEndogenous progesterone levelsRelapse prevention strategiesCurrent pilot studyPreliminary findingsPostpartum smokersMicronized progesteronePlacebo groupProgesterone groupProgesterone replacementEligible womenSecondary outcomesAdverse eventsPoint prevalencePostpartum women
2015
Substance Use in the Perinatal Period
Forray A, Foster D. Substance Use in the Perinatal Period. Current Psychiatry Reports 2015, 17: 91. PMID: 26386836, PMCID: PMC4671272, DOI: 10.1007/s11920-015-0626-5.Peer-Reviewed Original ResearchConceptsPerinatal substance usePerinatal periodSubstance useMajor public health problemPublic health problemUse of tobaccoFetal outcomesFetal effectsFetal healthCurrent treatmentPsychosocial interventionsPolysubstance useHealth problemsNovel interventionsMost efficacyCocaine useIllicit substancesContingency managementPregnancyInterventionTreatmentOpioidsTobaccoProgesteroneRecent literaturePerinatal substance use: A prospective evaluation of abstinence and relapse
Forray A, Merry B, Lin H, Ruger JP, Yonkers KA. Perinatal substance use: A prospective evaluation of abstinence and relapse. Drug And Alcohol Dependence 2015, 150: 147-155. PMID: 25772437, PMCID: PMC4387084, DOI: 10.1016/j.drugalcdep.2015.02.027.Peer-Reviewed Original ResearchConceptsRates of abstinenceMean daysSubstance useMultivariate Cox modelLittle prospective dataPostpartum relapseRelapse postpartumAbstinence ratesProspective evaluationNicotine cigarettesProspective dataCox modelPregnancyRelapseCigarettesAbstinenceToxicology testingCocaineWomenPsychological treatmentLast monthPostpartumMarijuanaSpecific substancesDays
2014
Pregnant Women With Posttraumatic Stress Disorder and Risk of Preterm Birth
Yonkers KA, Smith MV, Forray A, Epperson CN, Costello D, Lin H, Belanger K. Pregnant Women With Posttraumatic Stress Disorder and Risk of Preterm Birth. JAMA Psychiatry 2014, 71: 897-904. PMID: 24920287, PMCID: PMC4134929, DOI: 10.1001/jamapsychiatry.2014.558.Peer-Reviewed Original ResearchConceptsMajor depressive episodePosttraumatic stress disorderPreterm birthWeeks of pregnancyPregnant womenDepressive episodeModified PTSD Symptom ScalePTSD Symptom ScaleStress disorderBenzodiazepine medicationLikely diagnosisSymptom ScaleComposite International Diagnostic InterviewProspective cohort studySerotonin reuptake inhibitorsLogistic regression analysisCohort studyMedication useReuptake inhibitorsBenzodiazepine treatmentBenzodiazepine usePsychotropic treatmentObstetrical practicePsychiatric illnessAnxiolytic treatment
2013
Perinatal smoking and depression in women with concurrent substance use
Forray A, Gotman N, Kershaw T, Yonkers KA. Perinatal smoking and depression in women with concurrent substance use. Addictive Behaviors 2013, 39: 749-756. PMID: 24447885, PMCID: PMC3944019, DOI: 10.1016/j.addbeh.2013.12.008.Peer-Reviewed Original ResearchConceptsPregnant womenConcurrent substance useSubstance usePre-pregnancy smokersSignificant depressive symptomsWeeks of pregnancyMini Neuropsychiatric InterviewDiagnosis of depressionImpact of depressionCourse of smokingNon-depressed groupLinear mixed effects regressionSubstance abuse treatmentPerinatal smokingSmoking postpartumBaseline cohortNeuropsychiatric InterviewMixed effects regressionDepressive symptomsSmokingSmoking behaviorDepressive symptomatologyAbuse treatmentPregnancyPostpartumAntidepressant Use in Pregnant and Postpartum Women
Yonkers KA, Blackwell KA, Glover J, Forray A. Antidepressant Use in Pregnant and Postpartum Women. Annual Review Of Clinical Psychology 2013, 10: 369-392. PMID: 24313569, PMCID: PMC4138492, DOI: 10.1146/annurev-clinpsy-032813-153626.Peer-Reviewed Original ResearchConceptsAntidepressant usePersistent pulmonary hypertensionAdverse birth outcomesNeonatal complicationsShortened gestationPulmonary hypertensionAntidepressant exposureBirth outcomesPregnant womenPostpartum womenFetal growthMajor teratogensReproductive yearsLate pregnancyNeonatal signsCardiac malformationsAntidepressantsPregnancyAnxiety disordersAdverse effectsInconclusive evidenceWomenInconsistent literatureMalformationsRisk
2012
Motivational enhancement therapy coupled with cognitive behavioral therapy versus brief advice: a randomized trial for treatment of hazardous substance use in pregnancy and after delivery
Yonkers KA, Forray A, Howell HB, Gotman N, Kershaw T, Rounsaville BJ, Carroll KM. Motivational enhancement therapy coupled with cognitive behavioral therapy versus brief advice: a randomized trial for treatment of hazardous substance use in pregnancy and after delivery. General Hospital Psychiatry 2012, 34: 439-449. PMID: 22795046, PMCID: PMC3428516, DOI: 10.1016/j.genhosppsych.2012.06.002.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyMotivational enhancement therapyMET-CBTEnhancement therapyBehavioral therapySubstance useHazardous substance useBrief advicePregnant substance usersMonths postdeliverySubstance usersHospital outpatient clinicSubstance-using womenWeeks of pregnancySubstance misuseSimilar therapeutic effectsPercentage of daysSelf-reported percentageBiological measuresPreterm birthStudy nursesPrimary outcomeOutpatient clinicPrenatal careTherapeutic effect
2010
Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period.
Forray A, Focseneanu M, Pittman B, McDougle CJ, Epperson CN. Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period. The Journal Of Clinical Psychiatry 2010, 71: 1061-8. PMID: 20492843, PMCID: PMC4204467, DOI: 10.4088/jcp.09m05381blu.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdolescentAdultAge of OnsetAgedComorbidityDiagnostic and Statistical Manual of Mental DisordersFemaleHumansMaleMenarcheMiddle AgedObsessive-Compulsive DisorderParturitionPregnancyPregnancy ComplicationsPremenstrual SyndromePsychiatric Status Rating ScalesPuerperal DisordersReproductive HistoryRetrospective StudiesSeverity of Illness IndexConceptsOnset of OCDObsessive-compulsive disorderOCD onsetPregnant groupPerinatal periodOCD symptomsWorsening of symptomsExacerbation of symptomsImpact of pregnancyDSM-IV disordersStructured Clinical InterviewDSM-IV criteriaStudent's t-testPremenstrual worseningTotal pregnanciesSymptom exacerbationPostpartum periodExacerbationPregnancyClinical InterviewOCD clinicReproductive life cycleSymptom severitySymptomsCategorical variables
2009
Prevalence of post-traumatic stress disorder in pregnant women with prior pregnancy complications
Forray A, Mayes LC, Magriples U, Epperson CN. Prevalence of post-traumatic stress disorder in pregnant women with prior pregnancy complications. The Journal Of Maternal-Fetal & Neonatal Medicine 2009, 22: 522-527. PMID: 19488936, PMCID: PMC4109276, DOI: 10.1080/14767050902801686.Peer-Reviewed Original ResearchConceptsPrior pregnancy complicationsPartial post-traumatic stress disorderClinician-Administered PTSD ScalePost-traumatic stress disorderPregnancy complicationsPregnant womenPrevalence of PTSDStress disorderFull post-traumatic stress disorderFull PTSD symptomsPregnancy-related complicationsPatient-rated versionReferral clinicComplicationsPTSD ScalePrevalencePTSD symptomsAnonymous questionnaireWomenComparison groupCommon typeDisordersQuestionnaireAdditional evidenceClinic