TY - JOUR
KW - Adult
KW - African Americans/statistics & numerical data
KW - Buprenorphine/therapeutic use
KW - Child Custody/statistics & numerical data
KW - European Continental Ancestry Group/statistics & numerical data
KW - Female
KW - Healthcare Disparities/statistics & numerical data
KW - Hispanic Americans/statistics & numerical data
KW - Humans
KW - Infant, Newborn
KW - Male
KW - Massachusetts/epidemiology
KW - Methadone/therapeutic use
KW - Neonatal Abstinence Syndrome/epidemiology
KW - Opiate Substitution Treatment/statistics & numerical data
KW - Opioid-Related Disorders/complications/drug therapy
KW - Pregnancy
KW - Pregnancy Complications/drug therapy
AU - M. Peeler
AU - M. Gupta
AU - P. Melvin
AU - A. S. Bryant
AU - H. Diop
AU - R. Iverson
AU - K. Callaghan
AU - E. M. Wachman
AU - R. Singh
AU - M. Houghton
AU - S. F. Greenfield
AU - D. M. Schiff
A1 - 
AB - Objectives. To examine the extent to which differences in medication for opioid use disorder (MOUD) in pregnancy and infant neonatal opioid withdrawal syndrome (NOWS) outcomes are associated with maternal race/ethnicity.Methods. We performed a secondary analysis of a statewide quality improvement database of opioid-exposed deliveries from January 2017 to April 2019 from 24 hospitals in Massachusetts. We used multivariable mixed-effects logistic regression to model the association between maternal race/ethnicity (non-Hispanic White, non-Hispanic Black, or Hispanic) and prenatal receipt of MOUD, NOWS severity, early intervention referral, and biological parental custody at discharge.Results. Among 1710 deliveries to women with opioid use disorder, 89.3% (n = 1527) were non-Hispanic White. In adjusted models, non-Hispanic Black women (AOR = 0.34; 95% confidence interval [CI] = 0.18, 0.66) and Hispanic women (AOR = 0.43; 95% CI = 0.27, 0.68) were less likely to receive MOUD during pregnancy compared with non-Hispanic White women. We found no statistically significant associations between maternal race/ethnicity and infant outcomes.Conclusions. We identified significant racial/ethnic differences in MOUD prenatal receipt that persisted in adjusted models. Research should focus on the perspectives and treatment experiences of non-Hispanic Black and Hispanic women to ensure equitable care for all mother-infant dyads.
AD - Mary Peeler is with the Johns Hopkins School of Medicine, Baltimore, MD. Munish Gupta and Mary Houghton are with the Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA. Patrice Melvin is with Center for Applied Pediatric Quality Analytics, Boston Children's Hospital, Boston. Allison S. Bryant is with the Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston. Hafsatou Diop is with the Massachusetts Department of Public Health, Boston. Ronald Iverson is with the Department of Obstetrics and Gynecology, Boston Medical Center, Boston. Katherine Callaghan is with the Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worchester, MA. Elisha M. Wachman is with the Division of Neonatology, Department of Pediatrics, Boston Medical Center. Rachana Singh is with the Division of Newborn Medicine, Baystate Children's Hospital, Springfield, MA. Shelly F. Greenfield is with the Division of Women's Mental Health and Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, MA. Davida M. Schiff is with the Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston.; Mary Peeler is with the Johns Hopkins School of Medicine, Baltimore, MD. Munish Gupta and Mary Houghton are with the Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA. Patrice Melvin is with Center for Applied Pediatric Quality Analytics, Boston Children's Hospital, Boston. Allison S. Bryant is with the Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston. Hafsatou Diop is with the Massachusetts Department of Public Health, Boston. Ronald Iverson is with the Department of Obstetrics and Gynecology, Boston Medical Center, Boston. Katherine Callaghan is with the Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worchester, MA. Elisha M. Wachman is with the Division of Neonatology, Department of Pediatrics, B(TRUNCATED)
BT - American Journal of Public Health
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 12
DO - 10.2105/AJPH.2020.305888
IS - 12
JF - American Journal of Public Health
LA - eng
M1 - Journal Article
N2 - Objectives. To examine the extent to which differences in medication for opioid use disorder (MOUD) in pregnancy and infant neonatal opioid withdrawal syndrome (NOWS) outcomes are associated with maternal race/ethnicity.Methods. We performed a secondary analysis of a statewide quality improvement database of opioid-exposed deliveries from January 2017 to April 2019 from 24 hospitals in Massachusetts. We used multivariable mixed-effects logistic regression to model the association between maternal race/ethnicity (non-Hispanic White, non-Hispanic Black, or Hispanic) and prenatal receipt of MOUD, NOWS severity, early intervention referral, and biological parental custody at discharge.Results. Among 1710 deliveries to women with opioid use disorder, 89.3% (n = 1527) were non-Hispanic White. In adjusted models, non-Hispanic Black women (AOR = 0.34; 95% confidence interval [CI] = 0.18, 0.66) and Hispanic women (AOR = 0.43; 95% CI = 0.27, 0.68) were less likely to receive MOUD during pregnancy compared with non-Hispanic White women. We found no statistically significant associations between maternal race/ethnicity and infant outcomes.Conclusions. We identified significant racial/ethnic differences in MOUD prenatal receipt that persisted in adjusted models. Research should focus on the perspectives and treatment experiences of non-Hispanic Black and Hispanic women to ensure equitable care for all mother-infant dyads.
PY - 2020
SN - 1541-0048; 0090-0036; 0090-0036
SP - 1828
EP - 1836
EP - 
T1 - Racial and Ethnic Disparities in Maternal and Infant Outcomes Among Opioid-Exposed Mother-Infant Dyads in Massachusetts (2017-2019)
T2 - American Journal of Public Health
TI - Racial and Ethnic Disparities in Maternal and Infant Outcomes Among Opioid-Exposed Mother-Infant Dyads in Massachusetts (2017-2019)
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 33058701
U3 - 10.2105/AJPH.2020.305888
VL - 110
VO - 1541-0048; 0090-0036; 0090-0036
Y1 - 2020
Y2 - Dec
ER -