Complications and Hospital Admissions among Pregnant Women with Substance Abuse

Abstract

In recent times, there has been an increase in drug abuse in not only the general population, but in women of reproductive age. Our objectives were to identify, classify, and describe the spectrum of complications, the average number of admissions, and length of hospital stay that occur among pregnant women with substance abuse. The aim was to obtain better understanding of complication prevalence to improve management in this ever-growing population. A retrospective chart review was conducted of pregnant women ages 18-45 with a history of substance abuse from 2013-2018 in the tri-state area of West Virginia, Ohio, and Kentucky. We collected the following data: demographics, medical history, specific substances abused, inpatient admission dates and diagnoses, and delivery information. A total of 411 patients met the inclusion criteria, with a total of 525 pregnancies. Out of 525 pregnancies, 71.6 % used buprenorphine (i.e., Subutex), 43.4% used opiates, excluding heroin, and 35% of patients used heroin. Out of the 525 pregnancies, there were 714 inpatient antepartum admissions. Of these, 376 were admissions due to withdrawal symptoms (52.7%). A total of 263 pregnancies had at least one admission for withdrawal, drug abuse, overdose, or buprenorphine/methadone conversion (50%). The average length of hospital stay for withdrawal admissions was 3.4 days (SD). There were 62 admissions for infectious causes, 24 of these being due to pyelonephritis (38.7%). The findings highlight multiple areas for future studies as well as areas for quality improvement in the management of this population.