ArticleJournal of addiction medicine2025
Maternal Opioid-related Diagnosis in Pregnancy and Risk of Adverse Perinatal Outcomes.
Article in Journal of addiction medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine the associations between opioid-related diagnoses in pregnancy and maternal and neonatal outcomes in a large, diverse population-based cohort.
methodsThis is a retrospective cohort study of California linked hospital discharge-vital statistics data from 2008 to 2020. We included singleton pregnancies with gestational age of 23-42 weeks. Data analysis was completed on May 17, 2025. Opioid-related diagnosis, maternal morbidity, and neonatal outcomes were identified using ICD-9 and ICD-10 codes from hospital discharge data. χ 2 and multivariable Poisson regression models with robust variance estimator were utilized for statistical analyses.
resultsA total of 5,546,744 pregnancies met the inclusion criteria, and 13,749 (0.25%) had an opioid-related diagnosis. The prevalence of an opioid-related diagnosis increased from 0.14% in 2008 to 0.33% in 2020 ( P < 0.001) in pregnant individuals. Individuals with opioid-related diagnoses were associated with a higher risk of hypertensive disease (aRR = 1.23; 95% CI: 1.18-1.29), severe maternal morbidity (SMM; aRR = 1.84, 95% CI: 1.68-2.01), nontransfusion SMM (aRR = 2.16; 95% 1.87-2.49) and blood transfusion (aRR = 1.77; 95% 1.60-1.96). Neonates of individuals with an opioid-related diagnosis had higher risk of infant death (aRR = 1.72, 95% CI: 1.44-2.05), preterm birth <37 weeks (aRR = 1.71; 95% CI: 1.64-1.77), NICU admission (aRR = 2.80, 95% CI: 2.74-2.86), respiratory distress syndrome (aRR = 2.40, 95% CI: 2.28-2.53), and neonatal abstinence syndrome (aRR = 70.18, 95% CI: 64.34-76.56).
conclusionsOver the past decade, rates of an opioid-related diagnosis in pregnant individuals have more than doubled. In this large, diverse, population-based cohort study, a prenatal opioid-related diagnosis was associated with a significantly increased risk of maternal and neonatal morbidity.
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