Maternal Factors and Neonatal Morbidity Associated With Opioid Use in Pregnancy [36L

Abstract

INTRODUCTION: To identify the maternal factors and neonatal outcomes associated with opioid use in pregnancy. METHODS: This is a retrospective study of 16,980 term, singleton deliveries in a single hospital system from 2013-2014. Cases of opioid use during pregnancy (n = 1,648) were compared to unaffected pregnancies (n = 15,332) via logistic regression. RESULTS: In terms of maternal factors, opioid use was associated with black race (OR 2.78), gestational age greater than or equal to 41 weeks (OR 1.25), smoking (OR 1.66), history of drug use (OR 1.59), and history of any psychiatric disorder (OR 1.38). Multiparity was protective against opioid use (OR 0.48). For intrapartum factors, opioid use was associated with induction of labor (OR 2.42), use of antihypertensive medications (OR 1.79), severe perineal lacerations (OR 1.59), chorioamnionitis (OR 2.29), postpartum hemorrhage (OR 3.02), and operative or wound complications (OR 4.85). For neonatal outcomes, opioid use was associated with abstinence syndrome (OR 5.17), major birth defects (OR 2.65), and umbilical arterial pH less than 7.0 (OR 2.65). CONCLUSION: There are distinct demographic, social, medical, and obstetrical correlates of opioid use in pregnancy. Major maternal adverse associations include operative and wound complications and postpartum hemorrhage, while major neonatal adverse associations include abstinence syndrome and decreased umbilical arterial pH.