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01-04-2017

The Prevalence and Impact of Substance Use Disorder and Treatment on Maternal Obstetric Experiences and Birth Outcomes Among Singleton Deliveries in Massachusetts

Authors: Milton Kotelchuck, Erika R. Cheng, Candice Belanoff, Howard J. Cabral, Hermik Babakhanlou-Chase, Taletha M. Derrington, Hafsatou Diop, Stephen R. Evans, Judith Bernstein

Published in: Maternal and Child Health Journal | Issue 4/2017

Abstract

Objectives Despite widely-known negative effects of substance use disorders (SUD) on women, children, and society, knowledge about population-based prevalence and impact of SUD and SUD treatment during the perinatal period is limited. Methods Population-based data from 375,851 singleton deliveries in Massachusetts 2003–2007 were drawn from a maternal-infant longitudinally-linked statewide dataset of vital statistics, hospital discharges (including emergency department (ED) visits), and SUD treatment records. Maternal SUD and SUD treatment were identified from 1-year pre-conception through delivery. We determined (1) the prevalence of SUD and SUD treatment; (2) the association of SUD with women’s perinatal health service utilization, obstetric experiences, and birth outcomes; and (3) the association of SUD treatment with birth outcomes, using both bivariate and adjusted analyses. Results 5.5% of Massachusetts’s deliveries between 2003 and 2007 occurred in mothers with SUD, but only 66% of them received SUD treatment pre-delivery. Women with SUD were poorer, less educated and had more health problems; utilized less prenatal care but more antenatal ED visits and hospitalizations, and had worse obstetric and birth outcomes. In adjusted analyses, SUD was associated with higher risk of prematurity (AOR 1.35, 95% CI 1.28–1.41) and low birth weight (LBW) (AOR 1.73, 95% CI 1.64–1.82). Women receiving SUD treatment had lower odds of prematurity (AOR 0.61, 95% CI 0.55–0.68) and LBW (AOR 0.54, 95% CI 0.49–0.61). Conclusions for Practice SUD treatment may improve perinatal outcomes among pregnant women with SUD, but many who need treatment don’t receive it. Longitudinally-linked existing public health and programmatic records provide opportunities for states to monitor SUD identification and treatment.

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Title: The Prevalence and Impact of Substance Use Disorder and Treatment on Maternal Obstetric Experiences and Birth Outcomes Among Singleton Deliveries in Massachusetts
Authors: Milton Kotelchuck
Erika R. Cheng
Candice Belanoff
Howard J. Cabral
Hermik Babakhanlou-Chase
Taletha M. Derrington
Hafsatou Diop
Stephen R. Evans
Judith Bernstein
Publication date: 01-04-2017
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 4/2017
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-016-2190-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Prevalence and Impact of Substance Use Disorder and Treatment on Maternal Obstetric Experiences and Birth Outcomes Among Singleton Deliveries in Massachusetts

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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