ArticleAlcoholism, clinical and experimental research2021
Association of alcohol and other substance-related diagnoses with severe maternal morbidity.
Article in Alcoholism, clinical and experimental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- A Systematic Review of International Guidelines for Addressing Alcohol Use Disorder in Pregnancy.Alcohol, clinical & experimental research · 2026Pooled it
- Alcohol and pregnancy: Benefits and harms of pregnancy-specific alcohol policies among maternal-infant dyads covered by Medicaid.Drug and alcohol dependence · 2026Article
- Discontinuation of treatment for alcohol use disorder during pregnancy and postpartum in the United States.Alcohol, clinical & experimental research · 2025Article
- Emergency care utilization in persons with substance related diagnoses.Addictive behaviors reports · 2024Article
- Listen to the Whispers before They Become Screams: Addressing Black Maternal Morbidity and Mortality in the United States.Healthcare (Basel, Switzerland) · 2023Article
- Differences in outpatient, emergency, and inpatient use among pregnant women with a substance-related diagnosis.American journal of obstetrics & gynecology MFM · 2022Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPregnant women with a substance-related diagnosis, such as an alcohol use disorder, are a vulnerable population that may experience higher rates of severe maternal morbidity, such as hemorrhage and eclampsia, than pregnant women with no substance-related diagnosis.
methodsThis retrospective cross-sectional study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live birth or stillbirth at ≥ 20 weeks of gestation from March 1, 2016, to August 30, 2019. Women with and without a substance-related diagnosis were matched on key demographic characteristics, such as age, at a 1:1 ratio. Adjusting for these covariates, odds ratios and 95% confidence intervals were calculated.
resultsA total of 10,125 deliveries met the eligibility criteria for this study. In the matched cohort of 1,346 deliveries, 673 (50.0%) had a substance-related diagnosis, and 94 (7.0%) had severe maternal morbidity. The most common indicators in women with a substance-related diagnosis included hysterectomy (17.7%), eclampsia (15.8%), air and thrombotic embolism (11.1%), and conversion of cardiac rhythm (11.1%). Having a substance-related diagnosis was associated with severe maternal morbidity (adjusted odds ratio = 1.81 [95% CI, 1.14-2.88], p-value = 0.0126). In the independent matched cohorts by substance type, an alcohol-related diagnosis was significantly associated with severe maternal morbidity (adjusted odds ratio = 3.07 [95% CI, 1.58-5.95], p-value = 0.0009), while the patterns for stimulant- and nicotine-related diagnoses were not as well resolved with severe maternal morbidity and opioid- and cannabis-related diagnoses were not associated with severe maternal morbidity.
conclusionWe found that an alcohol-related diagnosis, although lowest in prevalence of the substance-related diagnoses, had the highest odds of severe maternal morbidity of any substance-related diagnosis assessed in this study. These findings reinforce the need to identify alcohol-related diagnoses in pregnant women early to minimize potential harm through intervention and treatment.
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