Understanding the Risk Factors for Overdose in Pregnant and Postpartum Patients With Opioid Use Disorder: A Scoping Review [ID 2683381

Abstract

INTRODUCTION: The rise in pregnant patients with opioid use disorder (OUD) has led to increased rates of pregnancy-associated deaths due to opioid-related overdoses. The aim of this scoping review is to describe the risk factors of opioid-related overdose in pregnant and postpartum patients. METHODS: We searched PubMed, CIANHL, EMBASE, Web of Science, Scopus, clinicaltrials.gov, and PsycINFO. We included studies that identified pregnant and/or postpartum patients with OUD and differentiated between those who experienced overdose and those who did not. Studies were screened by their title and abstract, and then by full text. Each study was independently screened by two researchers and conflicts were resolved by a group of three researchers. RESULTS: Of the 1,060 articles identified, eight met our criteria. These studies examined 90,860 pregnant and postpartum patients with evidence of OUD. The most frequently identified factor that reduced the risk of overdose was the consistent use of medications for OUD during pregnancy and the postpartum period. Other risk factors found included being houseless, incarcerated, young in age, unmarried, postpartum, publicly insured; not graduating high school; co-occurring substance use disorders; living in a state with punitive prenatal substance use policies; inadequate prenatal care; and complications in pregnancy. There was inconsistent information regarding the effect of race and co-occurring psychiatric disorders. CONCLUSION: This scoping review highlights risk factors for opioid overdose in pregnant and postpartum patients. The review indicates opportunities for future research and calls for the screening and provision of judgment-free services for high-risk individuals.