Year: 2022
Type: article
Study design: Observational Study
Abstract: Background: Opioid use has disproportionally impacted pregnant people and their fetuses. Previous studies describing opioid use among pregnant people are limited by geographic location, type of medical coverage, and small sample size. We described characteristics of a large, diverse group of pregnant people who were enrolled in the Environmental Influences on Child Health Outcomes (ECHO) Program, and determined which characteristics were associated with opioid use during pregnancy. Materials and Methods: Cross-sectional data obtained from 21,905 pregnancies of individuals across the United States enrolled in the ECHO between 1990 and 2021 were analyzed. Medical records, laboratory testing, and self-report were used to determine opioid-exposed pregnancies. Multiple imputation methods using fully conditional specification with a discriminant function accounted for missing characteristics data. Results: Opioid use was present in 2.8% ( n = 591) of pregnancies. The majority of people who used opioids in pregnancy were non-Hispanic White (67%) and had at least some college education (69%). Those who used opioids reported high rates of alcohol use (32%) and tobacco use (39%) during the pregnancy; although data were incomplete, only 5% reported heroin use and 86% of opioid use originated from a prescription. After adjustment, non-Hispanic White race, pregnancy during the years 2010–2012, higher parity, tobacco use, and use of illegal drugs during pregnancy were each significantly associated with opioid use during pregnancy. In addition, maternal depression was associated with increased odds of opioid use during pregnancy by more than two-fold (adjusted odds ratio 2.42, 95% confidence interval: 1.95–3.01). Conclusions: In this large study of pregnancies from across the United States, we found several factors that were associated with opioid use among pregnant people. Further studies examining screening for depression and polysubstance use may be useful for targeted interventions to prevent detrimental opioid use during pregnancy, while further elucidation of the reasons for use of prescription opioids during pregnancy should be further explored.
Source: Journal of Women s Health
Authors: Ruby H.N. Nguyen, Emily A. Knapp, Xiuhong Li, Carlos A. Camargo, Elisabeth Conradt, Whitney Cowell, Karen J. Derefinko, Amy J. Elliott, Alexander M. Friedman, Gurjit K. Khurana Hershey, Julie A. Hofheimer, Barry M. Lester, Cindy T. McEvoy, Jenae M. Neiderhiser, Emily Oken, Steven J. Ondersma, Sheela Sathyanarayana, Meagan E. Stabler, Annemarie Stroustrup, Irene Tung, Monica McGrath, On behalf of program collaborators for Environmental Influences on Child Health Outcomes
Institutions: University of Minnesota, Johns Hopkins University, Harvard University, Massachusetts General Hospital, University of Utah, Icahn School of Medicine at Mount Sinai, University of Tennessee Health Science Center, University of South Dakota, Columbia University Irving Medical Center, Columbia University, Cincinnati Children's Hospital Medical Center, University of Cincinnati, University of North Carolina at Chapel Hill, Brown University, Women & Infants Hospital of Rhode Island, Oregon Health & Science University, Pennsylvania State University, Harvard Pilgrim Health Care, Michigan State University, University of Washington, Seattle Children's Research Institute, Dartmouth College, Hofstra University, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, University of Pittsburgh
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Johns Hopkins University, RTI International, National Institutes of Health, Johns Hopkins Bloomberg School of Public Health, National Institute of Mental Health, National Center for Advancing Translational Sciences, Duke Clinical Research Institute, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: Childhood Allergy and the NeOnatal Environment (CANOE) ECHO Pediatric Follow-Up and New Enrollment, ECHO Renewal for the CANOE Study Cohort, Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-Up, Prenatal and Early Childhood Pathways To Health: An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory Outcomes, Common and distinct early environmental influences on cardiometabolic and respiratory health: Mechanisms and methods, Mount Sinai ECHO site for Perinatal Environment and Development Studies, Breaking the cycle of intergenerational disadvantage: neurodevelopment among Puerto Rican children., ENVIRONMENTAL INFLUENCES ON NEURODEVELOPMENTAL OUTCOME IN INFANTS BORN VERY PRETERM, Prenatal and Early Childhood Pathways To Health: An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory Outcomes, G9000082517, G9000129347, G9000169825, Prenatal Exposures and Child Health Outcomes 2: A Statewide Study of Michigan Families, Conduits: Mount Sinai Health System Translational Science Hub, The Early Growth and Development Study Cohort of the ECHO Program, A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort Study, Environmental influences on Child Health Outcomes (ECHO) Coordinating Center, Childhood Allergy and the NeOnatal Environment (CANOE) ECHO Pediatric Follow-Up and New Enrollment, Resilience to prenatal stress: Implications for offspring health and neurodevelopment, Environmental influences on Child Health Outcomes in the Northern Plains PASS-ECHO Cohort, Maternal Stress Resilience During Pregnancy and Offspring Emotion Regulation, Revisiting ReCHARGE: ECHO Follow up on Middle Childhood and Adolescence, ECHO DAC (Environmental Influences on Child Health Outcomes Data Analysis Center), Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-Up, Prenatal environmental determinants of health in young adulthood: a lifecourse approach, Environmental influences on Child Health Outcomes - The Colorado ECHO Pediatric Cohort, Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) following autism families in ECHO Phase 2, The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child Health
OpenAlex ID: W4308616808