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Epidemiology

Poster Session 4

(975) Racial Trends in Severe Maternal Morbidity Among Parturients With Opioid use disorder in the U.S.

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Opioid use disorder (OUD) is an epidemic in the U.S. and associated with increased risk for severe maternal morbidity (SMM). We evaluated temporal trends and associated risk of SMM among delivery hospitalizations with OUD by race and ethnicity in the U.S. from 2010 to 2020.

Study Design: Retrospective cohort study of U.S. delivery hospitalizations utilizing discharge data from the Healthcare Cost and Utilization Project National Inpatient Sample. ICD9-10 codes were used to identify OUD and SMM diagnoses. The primary aim was to compare the rate of SMM among those with OUD over a 10-year period (2010 vs 2020) by racial group (non-Hispanic White; NHW, non-Hispanic Black; NHB, and Hispanic). The annual percent change (APC) in SMM was determined by Joinpoint regression analysis. The adjusted RR of SMM among those with OUD by racial group was determined through multivariate regression analysis adjusting for co-existing risk factors.

Results:

From 2010-2020, delivery hospitalizations with OUD accounted for 272,610 (0.8%) births in the U.S. The rate of SMM per 10,000 delivery hospitalizations with OUD significantly increased in NHW (135 to 243; APC 5.9 CI 4.2-8.0) and NHB (385 to 720; APC 9.6 CI 4.3-19.5) parturients (Figure). There was no significant difference observed in the Hispanic parturients (APC 3.8 CI -4.3-16.4).  



As compared to the NHW group with OUD, the NHB group with OUD had an increased risk of SMM (aRR 2.3, CI 1.9-2.7). This was not observed among the Hispanic group (aRR 1.1, CI 0.9-1.4) after adjusting for demographic and comorbidity differences. When directly compared to NHB, Hispanic deliveries had a lower risk of SMM (aRR 0.5 CI 0.4-0.6). 


Conclusion: The rate of SMM at delivery hospitalization has significantly increased among NHB and NHW people with OUD, with SMM increasing disproportionately faster and higher among NHB people. This research can help guide future studies and initiatives on reducing and addressing disparities in maternal screening and delivery of care among those with OUD.