New research from Oregon Health & Science University (OHSU) reveals a concerning trend: the rate of opioid use during pregnancy has more than doubled over the past decade. Published in the Journal of Addiction Medicine, the study highlights significantly increased risks of maternal and infant health complications associated with opioid-related diagnoses during pregnancy.
The United States, known for its high opioid usage rates, is witnessing a parallel rise in prenatal opioid use. Despite this, most existing data on this issue comes from international studies, with U.S.-based research often limited in scope. “Given the prevalence and seriousness of this issue, we were surprised to see the lack of large-scale studies available,” said Jamie Lo, M.D., M.C.R., associate professor of obstetrics and gynecology at OHSU and the study’s lead author.
Understanding the Scope and Impact
The OHSU study is one of the largest population-based analyses to date, examining both maternal and infant health outcomes linked to opioid-related diagnoses in pregnancy over the last decade. “Sadly, we know many people who are using opioids while pregnant hesitate to ask for help due to the fear of judgement,” Lo noted. “Our goal is to support patients in a healthy pregnancy and transition to parenthood.”
The retrospective-cohort study utilized hospital data from California, involving over 5.5 million patients. Findings indicated that the prevalence of opioid-related diagnoses increased from 0.14% in 2008 to 0.33% in 2020, mirroring a national trend.
By the Numbers: Opioid-related diagnoses in pregnancy rose from 0.14% in 2008 to 0.33% in 2020.
Risks to Mothers and Infants
According to the study, prenatal opioid-related diagnoses are linked to a higher risk of adverse outcomes for infants, such as admissions to neonatal intensive care units, respiratory distress, preterm birth, and even death. Similarly, maternal outcomes showed increased risks for severe complications like hypertension, hemorrhage, and the need for blood transfusions.
The research team aims to further explore the unique impacts of opioid use on patients with additional conditions, including mental health disorders and the use of other substances. They also seek to understand the effects of different opioid classes and usage patterns.
Improving Care and Access
Addressing this growing issue requires urgent improvements in care access and delivery. Researchers emphasize a whole-health approach, integrating addiction medicine, primary care, and pediatric health providers. “Pregnant patients already face many difficulties in accessing care, and those with opioid-use disorders face additional barriers,” said Kristin Prewitt, M.D., M.P.H., co-author of the study.
In Oregon, efforts are underway to bridge these gaps. The Oregon Perinatal Collaborative (OPC) and Comagine Health have received funding to enhance substance-use care for pregnant individuals. Starting next year, health systems across the state can collaborate with OPC to improve care delivery.
“Here in Oregon, we have a huge problem of family separation due to addiction, and it’s because we don’t have adequate access to treatment and care,” Prewitt stated.
Looking Ahead
The implications of this study are profound, underscoring the need for systemic changes in how care is provided to pregnant individuals with opioid-use disorders. “Dr. Lo, Dr. Prewitt, and colleagues offer new insights into the troubling opioid epidemic in pregnancy with this impactful study,” said OHSU President Shereef Elnahal, M.D., M.B.A. “OHSU pledges to reduce stigma around this care when it is needed most.”
Research reported in this publication was supported by the National Institutes of Health, award number DA056793. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or other funders.
