Across the country, the number of pregnant women addicted to opioids more than quadrupled from 1999 to 2014, according to Centers for Disease Control and Prevention (CDC).

The analysis, published in CDC's Morbidity and Mortality Weekly Report, found increasing numbers of opioid use in pregnant women in all 28 states with available data. Opioid use includes drugs such as oxycodone, codeine, morphine, heroin and fentanyl. They can be prescribed or obtained illegally.

Opioid use by pregnant women is “a significant public health concern,” the report said. It can lead to devastating consequences, including:

  • preterm labor
  • stillbirth
  • neonatal abstinence syndrome (a group of conditions a baby suffers from as it withdraws from drugs it was exposed to in the womb)
  • maternal mortality.

Numbers are up across the country, but it's worse in some places than others

Researchers analyzed a national database that included information on women in 28 states. The opioid epidemic among pregnant women hit 6.5 out of 1,000 delivery hospitalizations in 2014. It was 1.5 per 1,000 delivery hospitalizations in 1999.

National Prevalence Of Opioid Use Disorder Per 1000 Delivery Hospitalizations National Inpatient Sample Nis Healthcare Cost And Utilization Project Hcup United States 19992014 1
National prevalence of opioid use disorder per 1,000 delivery hospitalizations — National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), United States, 1999–2014
Centers for Disease Control and Prevention

While the startling trend increased across the country, the rate of increase varied by state.

California had the lowest increase at 0.01 per 1,000 delivery hospitalizations per year.

Maine, New Mexico, Vermont, and West Virginia had the largest increase, with statistics ranging from 2.5 to 5.4 opioid-use disorder diagnoses per 1,000 delivery hospitalizations per year.

What doctors should know about pregnant women and opioids

The report finds that “excessive prescribing and challenges in accessing nonopioid treatments to control pain contribute to the rise in opioid use disorder.”

It points out that varying state policies on reporting and monitoring pregnant women and babies exposed to opioids can cause difficulties. For example, “23 states and DC consider substance use during pregnancy to be child abuse under child-welfare statutes, and three consider it grounds for civil commitment, which might result in women concealing substance use from their providers. However, data on the impact of these policies are scarce.”

The report also reminds prescribers that CDC and the American College of Obstetricians and Gynecologists (ACOG) guidelines recommend that clinicians should only prescribing opioids for chronic pain if the benefits outweigh the risks. And, before prescribing, they should “review the Prescription Drug Monitoring Program, provide contraception counseling and discuss risks of opioid use in pregnancy.”

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