TY - JOUR
AU - R. H. N. Nguyen
AU - E. A. Knapp
AU - X. Li
AU - C. A. Camargo
AU - E. Conradt
AU - W. Cowell
AU - K. J. Derefinko
AU - A. J. Elliott
AU - A. M. Friedman
AU - G. K. Khurana Hershey
AU - J. A. Hofheimer
AU - B. M. Lester
AU - C. T. McEvoy
AU - J. M. Neiderhiser
AU - E. Oken
AU - S. J. Ondersma
AU - S. Sathyanarayana
AU - M. E. Stabler
AU - A. Stroustrup
AU - I. Tung
AU - M. McGrath
A1 - 
AB - Background: Opioid use has disproportionally impacted pregnant people and their fetuses. Previous studies describing opioid use among pregnant people are limited by geographic location, type of medical coverage, and small sample size. We described characteristics of a large, diverse group of pregnant people who were enrolled in the Environmental Influences on Child Health Outcomes (ECHO) Program, and determined which characteristics were associated with opioid use during pregnancy. Materials and Methods: Cross-sectional data obtained from 21,905 pregnancies of individuals across the United States enrolled in the ECHO between 1990 and 2021 were analyzed. Medical records, laboratory testing, and self-report were used to determine opioid-exposed pregnancies. Multiple imputation methods using fully conditional specification with a discriminant function accounted for missing characteristics data. Results: Opioid use was present in 2.8% (n = 591) of pregnancies. The majority of people who used opioids in pregnancy were non-Hispanic White (67%) and had at least some college education (69%). Those who used opioids reported high rates of alcohol use (32%) and tobacco use (39%) during the pregnancy; although data were incomplete, only 5% reported heroin use and 86% of opioid use originated from a prescription. After adjustment, non-Hispanic White race, pregnancy during the years 2010-2012, higher parity, tobacco use, and use of illegal drugs during pregnancy were each significantly associated with opioid use during pregnancy. In addition, maternal depression was associated with increased odds of opioid use during pregnancy by more than two-fold (adjusted odds ratio 2.42, 95% confidence interval: 1.95-3.01). Conclusions: In this large study of pregnancies from across the United States, we found several factors that were associated with opioid use among pregnant people. Further studies examining screening for depression and polysubstance use may be useful for targeted interventions to prevent detrimental opioid use during pregnancy, while further elucidation of the reasons for use of prescription opioids during pregnancy should be further explored.
AD - Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychology, Pediatrics, Obstetrics/Gynecology, University of Utah, Salt Lake City, Utah, USA.; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, New York, USA.; Department of Preventative Medicine and Pharmacology, Addictive Science, and Toxicology, University of Tennessee, Memphis, Tennessee, USA.; Department of Pediatrics, Avera Research Institute, School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA.; Department of Obstetrics and Gynecology, School of Medicine, Columbia University, New York, New York, USA.; Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA.; Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Department of Psychiatry and Pediatrics, Center for the Study of Children at Risk, Alpert Medical School of Brown University and Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA.; Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA.; Department of Psychology, Penn State University, University Park, Pennsylvania, USA.; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.; Division of Public Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, Michigan State University, Flint, Michigan, USA.; Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, Washington, USA.; Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA.; Department of Pediatrics and Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
AN - 36350685
BT - J Womens Health (Larchmt)
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 2
DA - Feb
DO - 10.1089/jwh.2022.0118
DP - NLM
ET - 20221109
IS - 2
JF - J Womens Health (Larchmt)
LA - eng
N2 - Background: Opioid use has disproportionally impacted pregnant people and their fetuses. Previous studies describing opioid use among pregnant people are limited by geographic location, type of medical coverage, and small sample size. We described characteristics of a large, diverse group of pregnant people who were enrolled in the Environmental Influences on Child Health Outcomes (ECHO) Program, and determined which characteristics were associated with opioid use during pregnancy. Materials and Methods: Cross-sectional data obtained from 21,905 pregnancies of individuals across the United States enrolled in the ECHO between 1990 and 2021 were analyzed. Medical records, laboratory testing, and self-report were used to determine opioid-exposed pregnancies. Multiple imputation methods using fully conditional specification with a discriminant function accounted for missing characteristics data. Results: Opioid use was present in 2.8% (n = 591) of pregnancies. The majority of people who used opioids in pregnancy were non-Hispanic White (67%) and had at least some college education (69%). Those who used opioids reported high rates of alcohol use (32%) and tobacco use (39%) during the pregnancy; although data were incomplete, only 5% reported heroin use and 86% of opioid use originated from a prescription. After adjustment, non-Hispanic White race, pregnancy during the years 2010-2012, higher parity, tobacco use, and use of illegal drugs during pregnancy were each significantly associated with opioid use during pregnancy. In addition, maternal depression was associated with increased odds of opioid use during pregnancy by more than two-fold (adjusted odds ratio 2.42, 95% confidence interval: 1.95-3.01). Conclusions: In this large study of pregnancies from across the United States, we found several factors that were associated with opioid use among pregnant people. Further studies examining screening for depression and polysubstance use may be useful for targeted interventions to prevent detrimental opioid use during pregnancy, while further elucidation of the reasons for use of prescription opioids during pregnancy should be further explored.
PY - 2023
SN - 1540-9996 (Print); 1540-9996
SP - 161
EP - 170+
ST - Characteristics of Individuals in the United States Who Used Opioids During Pregnancy
T1 - Characteristics of Individuals in the United States Who Used Opioids During Pregnancy
T2 - J Womens Health (Larchmt)
TI - Characteristics of Individuals in the United States Who Used Opioids During Pregnancy
U1 - Opioids & Substance Use; Healthcare Disparities
U3 - 10.1089/jwh.2022.0118
VL - 32
VO - 1540-9996 (Print); 1540-9996
Y1 - 2023
ER -