CDC Says Opioid Abuse In Pregnant Women Has Quadrupled
Medical professionals are finding an unprecedented number of women with opioid use disorder (OUD) at labor or delivery, with the rates of pregnant women with OUD quadrupling between 1999 and 2014.
According to a new multistate study of trends from the Centers for Control and Disease, overall opioid use or addiction is not just rising. It is affecting some of the most vulnerable demographics more severely.
“These findings illustrate the devastating impact of the opioid epidemic on families across the US, including on the very youngest,” CDC Director Robert R. Redfield, MD, said in a news release.
OUD during pregnancy has been shown to increase the risk for a variety of serious health issues for mothers and their children, such as maternal death, preterm birth, stillbirth, and neonatal abstinence syndrome.
“Untreated opioid use disorder during pregnancy can lead to heartbreaking results,” Redfield noted. “Each case represents a mother, a child, and a family in need of continued treatment and support.”
According to the data published in the most recent issue of the CDC’s Morbidity and Mortality Weekly Report, the national prevalence rate of OUD at delivery increased from 1.5 per 1000 hospitalization in 1999 to 6.5 in 2014.
Among all 28 states with multiyear data available, the researchers found significant increases in OUD among pregnant women.
“Even in states with the smallest annual increases, more and more women are presenting with opioid use disorder at labor and delivery,” Wanda Barfield, MD, rear admiral, US Public Health Service, and director of the Division of Reproductive Health, said in the release.
“These state-level data can provide a solid foundation for developing and tailoring prevention and treatment efforts,” said Barfield.
While there were similar increases found in all the states included in the study, overall rates of OUD were notably varied depending on the state. Washington, DC and Nebraska had the lowest rates of OUD at delivery with 0.7 and 1.2 cases per 1000 births at a hospital. In comparison, West Virginia and Vermont accounted for the highest rates with 32.1 and 48.6 cases per 1000 hospital births.
The CDC believes this variance is likely the result of state-level differences in opioid prescribing rates, however, it may also reflect variances in screening or diagnosis of OUD in mothers within each state.
“This first multistate analysis of opioid use disorder among delivery hospitalizations can be used by states to monitor the prevalence of opioid use disorder at delivery hospitalizations. There is continued need for national, state, and provider efforts to prevent, monitor, and treat opioid use disorder among reproductive-aged and pregnant women,” the researchers explained.
In response to the findings, the CDC has devised several recommendations to address the rising rates of OUD among pregnant women:
- Ensure appropriate opioid prescribing, in line with current guidelines.
- Maximize and enhance prescription drug monitoring programs.
- Implement universal substance use screening at the first prenatal visit, as recommended by the American College of Obstetricians and Gynecologists.
- Ensure pregnant women with OUD have access to medication-assisted therapy and related addiction services.
- Ensure mothers with OUD receive adequate patient-centered postpartum care, including mental health and substance use treatment, relapse-prevention programs, and family planning services.