Prenatal Care Utilization Among Pregnant Women With Substance Use Disorder: A Drug-Free Moms and Babies Project Study [ID: 1377131

Abstract

INTRODUCTION: Pregnant people with substance use disorder (SUD) are more likely to have inadequate prenatal care quality/utilization. The rate of stimulants and opioids use continues to increase nationwide with significantly higher rates observed in rural and socioeconomically disadvantaged pregnant populations. The objective of this study was to quantify the association between substance use and the quality of prenatal care in the rural Appalachian pregnant population of West Virginia. METHODS: Drug-Free Moms and Babies Project is a multicenter program in West Virginia that offers coordinated care for pregnant and postpartum individuals with SUD. Secondary data analysis for this study (2018–2022) was limited to only those patients who entered the program during pregnancy (N=1,555). Kessner Index was used to categorize prenatal care quality as inadequate, intermediate, and adequate. Substance use included stimulants alone, opioids/narcotics alone, opioids/narcotics and stimulants concurrent use, and all other substances but not opioid/narcotic or stimulant use. RESULTS: Pregnant people with opioids use alone (odds ratio [OR] 2.11 [1.43–3.12]), stimulants use alone (OR, 3.27 [1.69–6.32]), and concurrent use of opioids and stimulants (OR 4.69 [2.52–8.73]) were more likely to have inadequate versus adequate prenatal care compared to those who used only other substances after adjusting for maternal income, education, medical conditions, prior children, planned/unplanned pregnancy, alcohol use, or smoking during pregnancy. CONCLUSION: Opioids/narcotics and stimulants use is associated with inadequate prenatal care utilization that becomes more pronounced with polysubstance use. Improving quality of prenatal care is critical for this population to improve the health of parent and child.