142nd APHA Annual Meeting and Exposition

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308201
Prevalence and Impact of Substance Abuse Disorder on Women's Use of Perinatal Health Services, Obstetric Experiences, and Birth Outcomes among Singleton Deliveries in Massachusetts: 2003-2007

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 5:30 PM - 5:50 PM

Milton Kotelchuck, MPH, PhD , MGH Center for Child & Adolescent Health Policy and Research, Harvard Medical School, Boston, MA
Erika Cheng, PhD, MPA , Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital for Children, Boston, MA
Steven Evans, MPH , Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
Hafsatou Diop, MD, MPH , Bureau of Family Health and Nutrition- Pregnancy Risk Assessment Monitoring System (PRAMS), Massachusetts Department of Public Health, Boston, MA
Taletha Derrington, PhD , Center for Education and Human Services, Education Division, SRI International, Menlo Park, CA
Hermik Babakhanlou-Chase, MPH , Bureau of Substance Abuse Services, Boston, MA
Candice Belanoff, ScD , Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
Howard Cabral, PhD, MPH , Biostatistics, Boston University School of Public Health, Boston, MA
Judith Bernstein, PhD, RNC , Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
Audio (mp3) recording Recorded Presentation (mp4)
Background: Despite the widespread effects of substance abuse disorders (SUD) on women, pregnancies, children, and society, we have only fragmentary and incomplete knowledge about the population-based prevalence and impact of SUD during the perinatal period. We examined the prevalence of SUD and its impact on perinatal health service utilization, obstetric experiences, and birth outcomes among singleton deliveries in MA between 2003-2007.

Methods: Data from 375,851 singleton deliveries were obtained from a linked statewide dataset of birth/fetal death certificates and hospital discharge and SUD treatment records in MA from 2003-2007. SUD was identified by the Explicit Mention Substance Abuse Need for Treatment in Women algorithm. Descriptive statistics examined differences in maternal characteristics, antenatal and postnatal emergency room (ER) visits, obstetric experiences (pregnancy and delivery complications, and prenatal care), and birth outcomes (prematurity and low birthweight) by SUD status. Generalized estimating equations were used to estimate the association between SUD and birth outcomes, adjusted for confounders.

Results: 20,707 or 5.5% of all deliveries were SUD-positive. SUD deliveries were twice as likely to have antenatal (21.3% vs. 40.8%) and postnatal (20.4% vs. 43.0%) ER visits; SUD was also associated with more pregnancy and delivery complications, and inadequate prenatal care. In adjusted analyses, SUD was associated with increased prematurity (AOR 1.35; 95% CI: 1.28-1.41) and low birthweight (AOR 1.73; 95% CI: 1.64-1.82).

Conclusions: SUD is prevalent among deliveries in MA and associated with poor outcomes for women and their neonates. This study underscores the need for substance use treatment for women of reproductive age.

Learning Areas:

Public health or related research

Learning Objectives:
Identify the prevalence of substance abuse disorders in a state-wide, population-based sample Determine the impact of substance abuse disorder on women’s use of perinatal health services, obstetric experiences, and birth outcomes Discuss the programmatic and policy implications of our findings

Keyword(s): Drug Abuse, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a postdoctoral fellow at Harvard Medical School and with the Division of General Academic Pediatrics and the Massachusetts General Hospital for Children.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4440.0: Women's health and social vulnerability: substance use, incarceration, and immigration