Development of a Substance Abuse Program for Opioid-Dependent Nonurban Pregnant Women Improves Outcome

Meyer, Marjorie; Benvenuto, Anna; Howard, Diantha B.; Johnston, Anne; Plante, Dennis A.; Metayer, Jerilyn; Mandell, Todd

doi:10.1097/adm.0b013e3182541933

Cited by 25 publications

(30 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous studies, this multiyear population-based study found an increasing prevalence of opioids use/abuse among pregnant women in the US [1, 3–5, 7, 10, 17, 25, 26]. In our previous investigation of national trends of opioid use among pregnant mothers in the US, we discuss the alarming overall increase, as well as geographic, regional, and sociodemographic differences in both the rate and trends of opioid use over 12 years [16].…”

Section: Discussionsupporting

confidence: 90%

Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

Whiteman

Salemi

Mogos³

et al. 2014

Journal of Pregnancy

131

View full text Add to dashboard Cite

Objective. To identify factors associated with opioid use during pregnancy and to compare perinatal morbidity, mortality, and healthcare costs between opioid users and nonusers. Methods. We conducted a cross-sectional analysis of pregnancy-related discharges from 1998 to 2009 using the largest publicly available all-payer inpatient database in the United States. We scanned ICD-9-CM codes for opioid use and perinatal outcomes. Costs of care were estimated from hospital charges. Survey logistic regression was used to assess the association between maternal opioid use and each outcome; generalized linear modeling was used to compare hospitalization costs by opioid use status. Results. Women who used opioids during pregnancy experienced higher rates of depression, anxiety, and chronic medical conditions. After adjusting for confounders, opioid use was associated with increased odds of threatened preterm labor, early onset delivery, poor fetal growth, and stillbirth. Users were four times as likely to have a prolonged hospital stay and were almost four times more likely to die before discharge. The mean per-hospitalization cost of a woman who used opioids during pregnancy was $5,616 (95% CI: $5,166–$6,067), compared to $4,084 (95% CI: $4,002–$4,166) for nonusers. Conclusion. Opioid use during pregnancy is associated with adverse perinatal outcomes and increased healthcare costs.

show abstract

Section: Discussionsupporting

confidence: 90%

Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

Whiteman

Salemi

Mogos³

et al. 2014

Journal of Pregnancy

131

View full text Add to dashboard Cite

show abstract

“…Throughout the study period, there were 9 WV federally funded opioid maintenance therapy (OMT) facilities that accepted pregnant women for the recommended OMT treatment, of which only 1 was located in the southeastern area of WV (Figure ) . Although OMT can result in NAS, the therapy is preferred over continued illegal substance use in order to improve obstetric and neonatal outcomes via decreased maternal illicit behaviors, improved prenatal care, and elimination of acute intoxication and withdrawal during pregnancy . Therefore, higher regional occurrence of adverse obstetric and neonatal health outcomes could be linked to the lack of available treatment options for this vulnerable population …”

Section: Discussionmentioning

confidence: 99%

Neonatal Abstinence Syndrome in West Virginia Substate Regions, 2007‐2013

Stabler

Long

Chertok

et al. 2016

The Journal of Rural Health

View full text Add to dashboard Cite

Purpose The opioid epidemic is a public health threat with consequences affecting newborns. Neonatal Abstinence Syndrome (NAS) is a constellation of withdrawal symptoms resulting primarily from in utero opioid exposure. The purpose of this study is to examine NAS and drug-specific trends in West Virginia (WV), where rurality-related issues are largely present. Methods The 2007–2013 WV Health Care Authority, Uniform Billing Data were analyzed for 119,605 newborn admissions with 1,974 NAS diagnoses. NAS (ICD9-CM 779.5) and exposure diagnostic codes for opioids, hallucinogens, and cocaine were utilized as incidence rate (IR) per 1,000 live births. Findings Between 2007 and 2013, NAS IR significantly increased from 7.74 to 31.56 per 1,000 live births per year (Z: −19.10, P < .0001). During this time period, opioid exposure increased (Z: −9.56, P < .0001), while cocaine exposure decreased (Z: 3.62, P = .0003). In 2013, the southeastern region of the state had the highest NAS IR of 48.76 per 1,000 live births. NAS infants were more likely to experience other clinical conditions, longer hospital stay, and be insured by Medicaid. Conclusions Statewide NAS IR increased four-fold over the study period, with rates over 3 times the national annual averages. This alarming trend is deleterious for the health of WV mother-child dyads and it strains the state’s health care system. Therefore, WV has a unique need for prenatal public health drug treatment and prevention resources, specifically targeting the southeastern region. Further examination of maternal drug-specific trends and general underutilization of neonatal exposure ICD-9-CM codes is indicated.

show abstract

“…Drug or alcohol use during pregnancy can have a negative impact medically and socially on both the mother and newborn (Shankaran et al, 2007;Terplan & Wright, 2011). Integrated treatment during pregnancy as well as early intervention for the newborn can ameliorate these negative effects (Meyer et al, 2012;Niccols et al, 2012;Peadon, Rhys-Jones, Bower, & Elliott, 2009).…”

Section: Recent Amendments To the Child Abuse Prevention And Treatmentmentioning

confidence: 98%

Screening, Testing, and Reporting for Drug and Alcohol Use on Labor and Delivery: A Survey of Maryland Birthing Hospitals

Miller

Lanham

Welsh

et al. 2014

Social Work in Health Care

View full text Add to dashboard Cite

Recent amendments to the Child Abuse Prevention and Treatment Act tie the receipt of federal block grants to mandatory reporting of substance-exposed newborns. To determine rates of screening, testing, and reporting of drug and alcohol use at the time of delivery, we administered a telephone survey of nursing managers and perinatal social workers at Maryland birthing hospitals. Of the 34 hospitals, 31 responded (response rate 91%). Although 97% of hospitals reported universal screening, only 6% used a validated instrument. Testing was reported by 94% with 45% reporting universal maternal testing and 7% universal newborn testing. Only 32% reported obtaining maternal consent prior to testing. There is significant heterogeneity in screening and testing for substance use in birthing hospitals. Given federal reporting mandates, state-level practices need to be standardized.

show abstract

Development of a Substance Abuse Program for Opioid-Dependent Nonurban Pregnant Women Improves Outcome

Abstract: Improved access to opioid agonist treatment programs for the general population in nonurban areas improves perinatal outcome and retention of maternal guardianship.

Cited by 25 publications

References 16 publications

Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

Neonatal Abstinence Syndrome in West Virginia Substate Regions, 2007‐2013

Screening, Testing, and Reporting for Drug and Alcohol Use on Labor and Delivery: A Survey of Maryland Birthing Hospitals

Contact Info

Product

Resources

About