Wednesday, November 22, 2023

Overdose Deaths During Pregnancy, Postpartum Period Rose From 2018 to 2021

From 2018 to 2021, drug overdose deaths rose significantly among pregnant and postpartum girls and women aged 10 to 44, according to a report published today in JAMA Psychiatry. Among pregnant and postpartum women aged 35 to 44 years, drug overdose deaths more than tripled—from 4.9 deaths per 100,000 mothers aged 35 to 44 with a live birth in the 2018 period to 15.8 per 100,000 in the 2021 period.

The study revealed that most of these overdose deaths occurred outside health care settings, indicating the need for strengthening community outreach and maternal medical support.

“The stigma and punitive policies that burden pregnant women with substance use disorder increase overdose risk by making it harder to access lifesaving treatment and resources,” National Institute on Drug Abuse (NIDA) Director Nora Volkow, M.D., who was senior author of the study, said in a news release. “Reducing barriers and the stigma that surrounds addiction can open the door for pregnant individuals to seek and receive evidence-based treatment and social support to sustain their health as well as their child’s health.”

For the study Volkow, Beth Han, M.D., Ph.D., M.P.H., and others at NIDA analyzed data from the National Center for Health Statistics, including cause of death files and semiannual numbers of mothers aged 10 to 44 years with a live birth. Pregnancy-associated mortality ratios were defined as deaths during pregnancy or within one year of delivery per 100,000 mothers with a live birth during each period. The researchers focused the analysis on three groups:

  • 1,457 individuals who died from overdose during pregnancy or the postpartum period.
  • 4,796 individuals who died from obstetric causes.
  • 11,205 individuals who died from overdose who were not pregnant in the past 12 months.

Compared with individuals who died from obstetric causes, those who died from drug overdose tended to be younger (age 10 to 34), unmarried, and more likely to die outside of health care settings.

Comparisons of health care resources at the county level revealed that “70% to 75% [of] pregnant and nonpregnant overdose decedents resided in counties with the number of physicians practicing emergency medicine per 100,000 population ranking over the 65th percentile among U.S. counties, suggesting that in many instances, emergency services may have been available but not accessed,” the researchers noted. Additionally, “51% to 53% resided in counties with two or more general hospitals with obstetric care ranking at the 95th percentile among U.S. counties, and 58% to 67% resided in counties with numbers of practicing psychiatrists per 100,000 county residents ranking over the 75th percentile among U.S. counties.”

“These results reflect the persistent national overdose crisis and demonstrate that pregnancy is an urgent time for interventions that can reduce the risk of overdose,” said Emily Einstein, Ph.D., NIDA Science Policy Branch Chief and study co-author. “Effective treatments and medical services exist—unfettered access is needed to help mothers and children survive.”

For related information, see the Psychiatric News article “Suicide, Overdose Are Significant Contributors to Pregnancy-Related Maternal Deaths.”

(Image: iStock/kieferpix)

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