Abstract
BackgroundLittle is known about opioid overdose or naloxone access among pregnant women.ObjectivesThe objectives of this study were to determine the prevalence of non-fatal overdose, risk factors for overdose, and naloxone access among third trimester women in treatment for opioid use disorder.MethodsWe collected baseline data from a case management parental-support intervention study. To explore the association of variables with past year overdose, we used Wilcoxon rank-sum test, Chi square or Fisher’s exact tests.ResultsAmong 99 participants, 14% (95% CI 7–21%) reported past year overdose and 67% (95% CI 57–76%) had received overdose education and a naloxone kit. Younger age was the only variable associated with past year overdose.ConclusionsIn this sample, past year non-fatal overdose was common, younger age was a risk factor, and most participants had received a naloxone kit. Further work is needed to understand whether younger age is a risk factor in the general population of pregnant women with opioid use disorder and to identify other potential risk factors for overdose in this population.
Highlights
Opioid use disorder among pregnant women quadrupled from 1999 to 2014 [5] and between 2004 and 2013, the incidence of neonatal intensive care unit admissions for neonatal abstinence syndrome increased from 7 cases to 27 cases per 1000 admissions per year [8]
Further work is needed to understand whether younger age is a risk factor in the general population of pregnant women with opioid use disorder and to identify other potential risk factors for overdose in this population
Of the 14 women who reported a past year overdose, all reported a major mental illness diagnosis. Of those with no past year overdose, 84% (n = 71) reported a major mental illness diagnosis. Among those who overdosed in the past year, the median number of reported overdoses during that time was one, and the maximum number was seven
Summary
Opioid use disorder among pregnant women quadrupled from 1999 to 2014 [5] and between 2004 and 2013, the incidence of neonatal intensive care unit admissions for neonatal abstinence syndrome increased from 7 cases to 27 cases per 1000 admissions per year [8]. This evidence of increased burden of the opioid epidemic on pregnant women has paralleled an increase in opioid-related overdose deaths among women that has been faster than among men [3, 6]. Recent research in Massachusetts demonstrated that 2.3% of newborns were delivered to women with opioid use disorder and detailed the falling and rising risk of opioid overdose across pregnancy. Little is known about opioid overdose or naloxone access among pregnant women
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