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IVP & Safe States News: Prescription Drug

The Number of Women with Opioid Use Disorder at Labor and Delivery Quadrupled

Friday, August 24, 2018   (0 Comments)
Posted by: Julie Alonso
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The Number of Women with Opioid Use Disorder at Labor and Delivery Quadrupled

First state-based analysis shows increases in all states studied


The number of pregnant women with opioid use disorder (OUD) at labor and delivery more than quadrupled from 1999 to 2014, according to a new analysis published today by the Centers for Disease Control and Prevention (CDC).This first-ever, multi-state analysis of trends reveals significant increases in the 28 states with available data.


People with OUD have a problematic pattern of opioid use that can result in health problems, disability, or failure to meet major responsibilities at work, school, or home.OUD during pregnancy has been associated with a range of negative health outcomes for both mothers and their babies including maternal death, preterm birth, stillbirth, and neonatal abstinence syndrome (NAS).


Using data from the Nationwide Inpatient Sample, researchers found that the national prevalence rate of OUD increased from 1.5 per 1,000 delivery hospitalizations in 1999, to 6.5 in 2014. On average, the national prevalence rate grew by 0.39 cases per 1,000 each year. Data from the State Inpatient Databases found significant increases in all 28 states with at least three years of data available for analysis. Over the study period, the average annual rate increases were lowest in California and Hawaii (growth of < 0.1 cases per 1,000 each year) and highest in Maine, New Mexico, Vermont, and West Virginia (all with growth of > 2.5 cases per 1,000 each year).The report notes that while variability by state may reflect differences in opioid prescribing rates or the prevalence of illicit drug use, it could also reflect improved screening, diagnosis, and treatment of OUD and NAS.


Some recommended strategies for addressing OUD among pregnant women include:


Reducing the burden of OUD on pregnant women and infants is a key component of CDC’s response. The agency is supporting state-based perinatal quality collaboratives (PQCs). These state or multi-state networks of teams are working to better identify women with OUD during pregnancy and standardize care for mothers and NAS-affected infants.

CDC is also improving data collection around OUD among pregnant women who recently gave birth. In 2016, CDC expanded the Pregnancy Risk Assessment Monitoring System (PRAMS) in some states to include questions that assess substance use before and during pregnancy. Additionally, CDC monitors and reports on the incidence of NAS among infants. To date, nine states have made NAS or the broader diagnosis of a substance-exposed infant reportable to state health departments. These data sources can provide a solid foundation for developing and tailoring OUD prevention and treatment efforts for pregnant women and women of reproductive age.

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