The prevalence and impact of substance use disorder and treatment on maternal obstetric experiences and birth outcomes among singleton deliveries in Massachusetts
Open accessAbstract
Objectives Despite widely-known negative effects of substance use disorders (SUD) on women, children, and society, knowledge about population-based prevalence and impact of SUD and SUD treatment during the perinatal period is limited. Methods Population-based data from 375,851 singleton deliveries in Massachusetts 2003-2007 were drawn from a maternal-infant longitudinally-linked statewide dataset of vital statistics, hospital discharges (including emergency department (ED) visits), and SUD treatment records. Maternal SUD and SUD treatment were identified from 1-year pre-conception through delivery. We determined (1) the prevalence of SUD and SUD treatment; (2) the association of SUD with women's perinatal health service utilization, obstetric experiences, and birth outcomes; and (3) the association of SUD treatment with birth outcomes, using both bivariate and adjusted analyses. Results 5.5% of Massachusetts's deliveries between 2003 and 2007 occurred in mothers with SUD, but only 66% of them received SUD treatment pre-delivery. Women with SUD were poorer, less educated and had more health problems; utilized less prenatal care but more antenatal ED visits and hospitalizations, and had worse obstetric and birth outcomes. In adjusted analyses, SUD was associated with higher risk of prematurity (AOR 1.35, 95% CI 1.28-1.41) and low birth weight (LBW) (AOR 1.73, 95% CI 1.64-1.82). Women receiving SUD treatment had lower odds of prematurity (AOR 0.61, 95% CI 0.55-0.68) and LBW (AOR 0.54, 95% CI 0.49-0.61). Conclusions for Practice SUD treatment may improve perinatal outcomes among pregnant women with SUD, but many who need treatment don't receive it. Longitudinally-linked existing public health and programmatic records provide opportunities for states to monitor SUD identification and treatment.
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Pregnant individuals with comorbid PTSD/SUD are at especially high risk for adverse perinatal outcomes.
“Pregnant individuals with comorbid PTSD and Substance Use Disorder (PTSD/SUD) are a subgroup that is at especially high risk for adverse perinatal outcomes [4,9].”
From Written exposure therapy for treatment of perinatal PTSD among women with comorbid PTSD and SUD: A pilot study examining feasibility, acceptability, and preliminary effectiveness (2023) · cites this paper as [9]
The Results section, “SUD and Birth Outcomes” (page unavailable), reports higher rates of low birthweight and prematurity among women with SUD. The Methods section, “Measures” (page unavailable), includes PTSD within a broad psychiatric-comorbidity variable, but the paper does not report perinatal outcomes specifically for the comorbid PTSD/SUD subgroup or establish that it is at especially high risk. (LLM, conf=0.88)
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Nillni, Y. I., Baul, T. D., Paul, E., Godfrey, L. B., Sloan, D. M., & Valentine, S. E. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.04.013 · Cited by 24 · see citing works
- Authors
- Kotelchuck, M., Cheng, E. R., Belanoff, C., Cabral, H. J., Babakhanlou-Chase, H., Derrington, T. M., Diop, H., Evans, S. R., & Bernstein, J.
- Affiliations
- Harvard University (US)
- Indiana University Indianapolis (US)
- Boston University (US)
- SRI International (US)
- Massachusetts Department of Public Health (US)
- Corresponding author
- Kotelchuck, Milton
- ORCID
- Venue
- Maternal and Child Health Journal
- Published
- 2016-11-10
- Volume
- 21
- Issue
- 4
- Pages
- 893-902
- ISSN
- 1092-7875 (ISSN-L)
- 1573-6628
- PMC
- PMC5380534
- OpenAlex
- W2549571577
- Cited by
- 89
- References
- 32
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 12 · 2023: 15 · 2022: 10 · 2021: 9 · 2020: 10 · 2019: 15 · 2018: 1 · 2017: 2
- FWCI
- 6.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Maternal and Child Health Journal (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- NIH NIAAA (R21AA018395)
- NIH NIDA (R21DA027181)
- Massachusetts Department of Public Health Bureau of Substance Abuse Services (Supplemental funding)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- substance use disorders, prenatal drug exposure, perinatal care, obstetric outcomes, birth outcomes, preterm birth, low birth weight, antenatal care utilization, maternal health disparities
- MeSH terms
- Adult, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Newborn, Diseases, Longitudinal Studies, Male, Massachusetts, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Risk Factors, Prevalence, Perinatal Care, Substance-Related Disorders
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