Co-occurring substance use disorders are common in pregnant women

1. Approximately 7% of pregnant women were diagnosed with at least one substance use disorder at delivery.

2. Many patients had co-occurring substance use disorders, the most common of which was tobacco and cannabis use disorders.

Evidence Rating Level: 2 (Good)

 In the past decade, research has demonstrated an increase in substance use in pregnancy, including opioid, amphetamine, and cannabis use. Each of these substances are associated with adverse fetal outcomes, including growth restriction and preterm birth. Multiple substance use disorders (SUDs) may exacerbate this issue. Thus, it is important to understand the prevalence of polysubstance abuse amongst pregnant women.

This study was a nationally representative stratified sample from the National Inpatient Sample (NIS) administered by the United States (US) Agency of Healthcare Research and Quality. Participants were included if they were aged 15-44 and had a hospital delivery between 2007 and 2016 (weighted N=38 million). Patients were excluded if they did not have a delivery hospitalization. Information about substance use disorders was collected through the diagnosis codes recorded from NIS.

This study showed that overall, 7.3% of women were diagnosed with at least one SUD, including tobacco, cannabis, opioid, amphetamine, alcohol, sedative, or cocaine. Co-occurring SUDs were also common, the most common combination being tobacco and cannabis. Those who used sedatives had an 83.7% chance of using at least one other substance. This study was limited in its use of diagnosis codes to categorize SUD (which likely underestimated the true prevalence of SUDs). Furthermore, there was limited information to differentiate whether these substances were prescribed and misused versus illicit substance use. Despite these limitations, this study encourages further study on the effect of multiple substances on pregnancy outcomes.

Click to read the study in Journal of Addiction Medicine

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