Urine drug screening on labor and delivery

Chin, Jennifer; Chen, Eileen; Wright, Tricia E.; Bravo, Ricardo M; Nakashima, Eryn; Kiyokawa, Miki; Karasaki, Kameko; Estrada, Pamela; Ghatnekar, Reema; Lee, Men‐Jean; Bartholomew, Marguerite Lisa

doi:10.1016/j.ajogmf.2022.100733

Cited by 7 publications

(10 citation statements)

References 8 publications

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“…Eight articles discussed disparities in detection based on the CDC social vulnerability domain of household characteristics. 33,37,38,[41][42][43][44][45] Seven articles included findings indicating disparities in detection based on age. 33,37,38,41,[43][44][45] Four of these seven articles found younger individuals were more likely to receive uTox than older individuals.…”

Section: Household Characteristicsmentioning

confidence: 99%

“…33,37,38,[41][42][43][44][45] Seven articles included findings indicating disparities in detection based on age. 33,37,38,41,[43][44][45] Four of these seven articles found younger individuals were more likely to receive uTox than older individuals. 37,41,43,45 In one of the seven studies, providers self-reported that younger age was associated with an increased likelihood of uTox among their patients.…”

Section: Household Characteristicsmentioning

confidence: 99%

“…33,37,38,41,[43][44][45] Four of these seven articles found younger individuals were more likely to receive uTox than older individuals. 37,41,43,45 In one of the seven studies, providers self-reported that younger age was associated with an increased likelihood of uTox among their patients. 33 One of the seven articles found that individuals who did not self-report substance use, but were identified as having used substances on uTox, were more likely to be older.…”

Section: Household Characteristicsmentioning

confidence: 99%

“…Seventeen of the 18 studies showed disparities in substance use detection based on race and/or ethnicity. [32][33][34][35][36][37][38][39][40][41][42][43][44][46][47][48][49] Racial and ethnic minority status was defined by self-report in 17 studies and by the investigator in 1 study. In the study where race and ethnicity were defined by the investigator, providers were interviewed about their detection practices.…”

Section: Racial and Ethnic Minority Statusmentioning

confidence: 99%

“…Twelve studies examined the relationship between race/ethnicity and the receipt of screening or uTox testing. [32][33][34][35]37,[39][40][41][42][43]46,49 Seven studies found that Black individuals were more likely than all other racial groups to receive uTox testing. 34,37,[39][40][41][42]49 In one of these seven studies, insurance modified the effect of race on the receipt of uTox and showed that non-Hispanic Black individuals with private insurance had increased odds of receiving uTox than non-Hispanic White individuals.…”

Section: Racial and Ethnic Minority Statusmentioning

confidence: 99%

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The Impact of Social Vulnerability on Substance Use Detection Practices in Pregnancy

Lijewski,

Aldrich,

Straub

2024

Am J Perinatol

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This study aimed to synthesize current literature regarding the impact of social vulnerability on pregnancy-related substance use detection in the United States and highlight disparities in substance use detection practices. Clinicaltrials.gov, Google Scholar, PubMed (includes MEDLINE), and Cochrane Library databases were searched using the following Medical Subject Headings (MeSH): ([“pregnancy” or “prenatal”] AND [“substance use screening” or “urine toxicology testing” or “toxicology testing” or “urine drug screening” or “CRAFFT” or “4P's” or “4P's Plus” or “NIDA Quick Screen” or “DAST-10” or “SURP-P” or “WIDUS”], AND (“bias” or “disparities” or “social vulnerability”]). The search included systematic reviews, prospective and retrospective studies, randomized controlled trials, case studies, and qualitative and quantitative research from January 2014 through November 2023. Selected literature was limited to studies published in English, which included a study population of either pregnant individuals or pregnancy health care providers in the United States, and that were focused on inequities in pregnancy substance use detection. Using Covidence, three authors screened abstracts, and two screened full articles for inclusion. The included studies were evaluated for quality of evidence using the mixed methods appraisal tool. The search yielded 4,188 manuscripts; 37 were eligible for full review. A total of 18 manuscripts were included based on the relevancy of the topic. The most common social vulnerability domain identified was minority status (17/18), followed by socioeconomic status (11/18), household characteristics (8/18), and housing type (1/18). Social vulnerability plays a role in substance use detection among pregnant individuals. Most notably, race and ethnicity, age, and public insurance lead to increased rates of detection, though most individual factors need to be studied in greater depth. This study was registered with PROSPERO (PROSPERO ID CRD42022352598), the International Prospective Register of Systematic Reviews. Key Points

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Section: Household Characteristicsmentioning

confidence: 99%

Section: Household Characteristicsmentioning

confidence: 99%

Section: Household Characteristicsmentioning

confidence: 99%

Section: Racial and Ethnic Minority Statusmentioning

confidence: 99%

Section: Racial and Ethnic Minority Statusmentioning

confidence: 99%

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The Impact of Social Vulnerability on Substance Use Detection Practices in Pregnancy

Lijewski,

Aldrich,

Straub

2024

Am J Perinatol

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A Retrospective Cohort Study of Disparities in Urine Drug Testing During the Perinatal Period in an Urban, Academic Medical Center

Ganetsky,

Yates,

Salzman

et al. 2024

Matern Child Health J

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The purpose of this study was to evaluate disparities in urine drug testing (UDT) during perinatal care at a single academic medical center. This retrospective cohort study included patients who had a live birth and received prenatal care at our institution between 10/1/2015 and 9/30/2020. The primary outcomes were maternal UDT during pregnancy (UDTPN) and UDT only at delivery (UDTDEL). Secondary outcomes included the number of UDTs (UDTNUM) and the association between a positive UDT test result and race/ethnicity. Mixed model logistic regression and negative binomial regression with clustering based on prenatal care locations were used to control for confounders. Of 6,240 live births, 2,265 (36.3%) and 167 (2.7%) received UDTPN and UDTDEL, respectively. Black (OR 2.09, 95% CI 1.54–2.84) and individuals of Other races (OR 1.64, 95% CI 1.03–2.64) had greater odds of UDTPN compared to non-Hispanic White individuals. Black (beta = 1.12, p < 0.001) and Hispanic individuals (beta = 0.78, p < 0.001) also had a positive relationship with UDTNUM. Compared to individuals with non-Medicaid insurance, those insured by Medicaid had greater odds of UDTPN (OR 1.66, 95% CI 1.11–2.49) and had a positive relationship with UDTNUM (beta = 0.89, p < 0.001). No significant associations were found for UDTDEL and race/ethnicity. Despite receiving more UDT, Black individuals were not more likely to have a positive test result compared to non-Hispanic White individuals (OR 0.95, 95% CI 0.72–1.25). Our findings demonstrate persistent disparities in substance use testing during the perinatal period.

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Opioid Use Disorder: Approach to Intrapartum and Postpartum Management

Sudhof,

Bernstein

2023

Curr Obstet Gynecol Rep

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Urine drug screening on labor and delivery

Cited by 7 publications

References 8 publications

The Impact of Social Vulnerability on Substance Use Detection Practices in Pregnancy

The Impact of Social Vulnerability on Substance Use Detection Practices in Pregnancy

A Retrospective Cohort Study of Disparities in Urine Drug Testing During the Perinatal Period in an Urban, Academic Medical Center

Opioid Use Disorder: Approach to Intrapartum and Postpartum Management

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