Characteristics of Individuals in the United States Who Used Opioids During Pregnancy

Nguyen, Ruby H.N.; Knapp, Emily A.; Li, Xiuhong; Camargo, Carlos A.; Conradt, Elisabeth; Cowell, Whitney; Derefinko, Karen J.; Elliott, Amy J.; Friedman, Alexander M.; Hershey, Gurjit K. Khurana; Hofheimer, Julie A.; Lester, Barry M.; McEvoy, Cindy T.; Neiderhiser, Jenaè M.; Oken, Emily; Ondersma, Steven J.; Sathyanarayana, Sheela; Stabler, Meagan E.; Stroustrup, Annemarie; Tung, Irene; McGrath, Monica

doi:10.1089/jwh.2022.0118

Cited by 7 publications

(5 citation statements)

References 41 publications

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“…This report highlights the significant increase in the use of opioids and stimulants in pregnancy, along with a constellation of other drugs (31,138,163). The opioids that are currently associated with prenatal use are immediate reward or short-acting OPRs, heroin or non-prescribed fentanyl (NPF), or illicitly manufactured fentanyl.…”

Section: Discussionmentioning

confidence: 99%

“…A large Canadian study comparing methadone maintenance treatment (MMT) with maintenance treatment with buprenorphine (BUP) found 92% of their sample reported mental health disorders (18). A recent study of 21,905 pregnant people in the Environmental Influences on Child Health Outcomes (ECHO) Program reporting opioid use (N = 591) found maternal depression was associated with an increased odds of opioid use during pregnancy by more than two-fold (aOR: 2.42, 95% CI: 1.95-3.01) (31).…”

Section: Maternal Outcomesmentioning

confidence: 99%

“…Understanding the characteristics of individuals and the risk factors associated with OUDs during pregnancy has policy, treatment, and clinical implications. Data from the US Environmental Influences on Child Health Outcomes (ECHO) Program obtained characteristics of 21,905 pregnancies that occurred between 1,990 and 2021 (31). Participants who used opioids during pregnancy were more likely to be non-Hispanic White (67%), have a lower socioeconomic status, and 69% reported some college education.…”

Section: The Context and Risk Factors Of Perinatal Outcomes In Ouds D...mentioning

confidence: 99%

“…This unifying measurement framework takes a lifespan development approach to assess how physical, mental, and social health interact within families across the life course to promote or hinder child health outcomes (181). Recent evidence from the ECHO program reported in this review provided the characteristics of 21,905 pregnant individuals who used opioids during pregnancy (31). For a comprehensive review of how the ECHO program can address the methodologic limitations associated with the current literature on maternal OUD and other SUDs, see Condradt et al (178).…”

Section: Addressing the Limitations And Gaps In Our Knowledgementioning

confidence: 99%

“…While many people who use licit and illicit psychoactive drugs may prefer a specific drug or drug class, polysubstance use is nearly ubiquitous in people with substance use disorders (SUDs) (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). In addition, polysubstance use during pregnancy is only one of several related risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Opioid, methamphetamine, and polysubstance use: perinatal outcomes for the mother and infant

Wouldes,

Lester

2023

Front. Pediatr.

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The escalation in opioid pain relief (OPR) medications, heroin and fentanyl, has led to an increased use during pregnancy and a public health crisis. Methamphetamine use in women of childbearing age has now eclipsed the use of cocaine and other stimulants globally. Recent reports have shown increases in methamphetamine are selective to opioid use, particularly in rural regions in the US. This report compares the extent of our knowledge of the perinatal outcomes of OPRs, heroin, fentanyl, two long-acting substances used in the treatment of opioid use disorders (buprenorphine and methadone), and methamphetamine. The methodological limitations of the current research are examined, and two important initiatives that will address these limitations are reviewed. Current knowledge of the perinatal effects of short-acting opioids, OPRs, heroin, and fentanyl, is scarce. Most of what we know about the perinatal effects of opioids comes from research on the long-acting opioid agonist drugs used in the treatment of OUDs, methadone and buprenorphine. Both have better perinatal outcomes for the mother and newborn than heroin, but the uptake of these opioid substitution programs is poor (<50%). Current research on perinatal outcomes of methamphetamine is limited to retrospective epidemiological studies, chart reviews, one study from a treatment center in Hawaii, and the US and NZ cross-cultural infant Development, Environment And Lifestyle IDEAL studies. Characteristics of pregnant individuals in both opioid and MA studies were associated with poor maternal health, higher rates of mental illness, trauma, and poverty. Infant outcomes that differed between opioid and MA exposure included variations in neurobehavior at birth which could complicate the diagnosis and treatment of neonatal opioid withdrawal (NOWs). Given the complexity of OUDs in pregnant individuals and the increasing co-use of these opioids with MA, large studies are needed. These studies need to address the many confounders to perinatal outcomes and employ neurodevelopmental markers at birth that can help predict long-term neurodevelopmental outcomes. Two US initiatives that can provide critical research and treatment answers to this public health crisis are the US Environmental influences on Child Health Outcomes (ECHO) program and the Medication for Opioid Use Disorder During Pregnancy Network (MAT-LINK).

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Section: Discussionmentioning

confidence: 99%

Section: Maternal Outcomesmentioning

confidence: 99%

Section: The Context and Risk Factors Of Perinatal Outcomes In Ouds D...mentioning

confidence: 99%