Opioid abuse during pregnancy is on the rise, new research suggests—and that’s likely to endanger both expectant mothers and their children.
Researchers at Oregon Health & Science University (OHSU) examined hospital data from pregnancies in California. They found that the annual prevalence of opioid use disorder among pregnant women more than doubled between 2008 and 2020. What’s more, reported opioid use was linked to worse maternal and newborn health outcomes, including a higher risk of infant death.
“In this large, diverse, population-based cohort study, a prenatal opioid-related diagnosis was associated with a significantly increased risk of maternal and neonatal morbidity,” the researchers wrote in their paper, published this month in the Journal of Addiction Medicine.
On the rise
While opioids are an important part of pain management, they can have dangerous side effects. People can develop an unhealthy dependance to these drugs (this is formally known as opioid use disorder), and acute opioid overdoses can quickly turn fatal.
Plenty of studies have documented how the drug and opioid crisis has worsened in the U.S. over the past several decades. But the OHSU authors say there’s been relatively little research looking at how rates of opioid use may have changed for pregnant women.
Their work analyzed data on hospital discharges from linked health care systems in California. This allowed them to look at over 5 million pregnancies documented in the state between 2008 and 2020.
While the overall percentage of pregnant women with opioid use disorder diagnoses remained low throughout the study period, it rose noticeably over time. In 2008, 0.14% of pregnant women had such a diagnosis; by 2020, this had increased to 0.33% of pregnant women—more than doubling in that time period.
Women who reported opioid use disorder during pregnancy were also more likely to have hypertension or to develop severe maternal complications, like hemorrhaging. Similarly, children born to these mothers were more likely to be born prematurely, to need neonatal intensive care, or to die.
What needs to happen
The findings can only show a correlation between maternal opioid use and worse health outcomes, not a direct cause-and-effect link. That said, other research supports the idea that opioid use can be a risk for both mother and child.
The authors of this paper point out that pregnant women are especially less likely to have the resources needed to treat unhealthy opioid use.
“Pregnant patients already face a lot of difficulties in accessing care, but individuals with opioid-use disorders face additional barriers,” said study co-author Kristin Prewitt, a fellow in OHSU’s section of addiction medicine and department of maternal-fetal medicine, in a statement from the university. “Here in Oregon, only one in four residential treatment programs offer care for pregnant persons, and some counties have no obstetric care or addiction care resources available at all.”
There have been some promising developments as of late. Annual drug and opioid overdose deaths in the U.S. have declined in recent years, for instance. But pregnant women dealing with opioid use disorder will need dedicated, comprehensive health care to help them and their children, the researchers say.
“Evidence shows that linking patients to care earlier improves outcomes. If we’re aware early on that an individual faces these additional risks, we can ensure they receive personalized, multidisciplinary care in the prenatal and postnatal periods, and ultimately when they move onto pediatric care with their child,” said Prewitt.
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