Opioid use disorder among pregnant women in the 2000–2014 North Carolina state inpatient database

Abstract

Background: The opioid epidemic’s impact reached an increasing portion of the United States population, including pregnant women.

Objectives: We sought to determine the prevalence and factors associated with opioid use disorders during pregnancy in North Carolina.

Study Design: Using North Carolina’s State Inpatient Sample, a retrospective study was conducted to identify pregnancy-related discharges between 2000 and 2014. Hospital discharge records associated with ICD-9-CM diagnoses codes for the use of opioids for all eligible pregnancy-related discharges were extracted. Logistic regression models were used to estimate unadjusted and adjusted bivariate and multivariate relationships.

Results: Of 1,937,455 pregnancy-related hospitalization in North Carolina, 6,084 were associated with opioid use, a prevalence of 3.14 cases per 1,000 discharge. Maternal opioid use was associated with an increased odds of early onset delivery, threatened preterm labor, premature rupture of membranes, postpartum depression, stillbirth and poor fetal growth. Women who used opioids during pregnancy had prolonged hospital stays (>5 days) and were 2 times as likely to have more than 4 procedures performed during hospitalization. Compared to other racial groups, non-Hispanic whites had a notably higher prevalence of opioid use disorders (5.8/1,000 pregnancy-related discharges) (P < 0.05 for all).

Conclusions: Very few health issues have garnered the attention of such diverse sectors of our society as the opioid epidemic. As the first state-level analysis of opioid use disorders among delivery hospitalizations, these findings suggest the need for a system-wide public health response such as improved funding for Medicaid and child welfare systems to improve the health of the opioid-exposed mother-infant dyad.

KEYWORDS:

• Opioid use disorder
• pregnancy
• North Carolina
• SID
• HCUP
• AHRQ

Acknowledgments

The authors acknowledge Dr. Brian Byrd and Dr. Dolly Pressley-Byrd for their contributions to this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study are publicly available and can be access from HCUP (https://www.hcup-us.ahrq.gov).

Additional information

Funding

This study was supported by Western Carolina University Provost’s Internal Funding Support Grant (WCU-PIFSG) through the award SFA001-222955 (PI: BA). B.A. has received support from Western Carolina University Provost’s Internal Funding Support Grant through the award SFA001-222955.