1224: Co-occurrence of psychiatric conditions and substance use disorders and effect on maternal and neonatal outcomes

Abstract

Psychiatric comorbidities have been shown to affect substance use, treatment completion, and health outcomes in non-pregnant patients with substance use disorders (SUD). The aim of this study is to compare adjusted odds of maternal and neonatal outcomes for women with co-occurrence of psychiatric conditions and SUD compared to women with only SUD. A retrospective analysis of a prospective, population-based cohort (2011-2019) from two large delivery hospitals was performed. Every consenting subject is asked, in their native language and using bias-free terms, about their frequency of substance use. Presence of psychiatric conditions was determined via chart review. Maternal baseline characteristics, co-morbidities and maternal and neonatal outcomes were collected. Women who have psychiatric conditions and SUD (Group 1, n=111) were compared to women with SUD who do not have psychiatric conditions (Group 2, n=372). Univariate analyses were performed using Chi-square, t-tests, Mann-Whitney U tests as appropriate. Logistic regression modeling was then used to control for potential confounders identified in the univariate analyses. 23% of pregnant women with SUD also have psychiatric conditions in this cohort. Outcomes which were significantly different after univariate analyses are shown in Figure 1. After adjusting for potential confounders, women with co-occurrence of SUD and psychiatric conditions were more like to have chronic hypertension (aOR 3.25, 95% CI 1.15-9.32), and more likely to require antepartum admission (aOR 3.014, 95% CI 1.34-6.81) than women without psychiatric conditions. There was also a statistically significant, but not clinically significant difference in 5 minute Apgar score (Group 1: 8.76, Group 2: 8.55, p=0.03). Co-occurrence of psychiatric disorder with SUD is common among pregnant women, and can impact outcomes for both mother and neonate. This data further supports the need for specialized care for this population, with integration of obstetrics, psychiatry, addiction medicine, and comprehensive social services.