Fatal and nonfatal overdose among pregnant and postpartum women in Massachusetts
Open accessAbstract
OBJECTIVE: To estimate fatal and nonfatal opioid overdose events in pregnant and postpartum women in Massachusetts, comparing rates in individuals receiving and not receiving pharmacotherapy for opioid use disorder (OUD). METHODS: We conducted a population-based retrospective cohort study using linked administrative and vital statistics databases in Massachusetts to identify women with evidence of OUD who delivered a liveborn neonate in 2012–2014. We described maternal sociodemographic, medical, and substance use characteristics, computed rates of opioid overdose events in the year before and after delivery, and compared overdose rates by receipt of pharmacotherapy with methadone or buprenorphine in the prenatal and postpartum periods. RESULTS: Among 177,876 unique deliveries, 4,154 (2.3%) were to women with evidence of OUD in the year before delivery, who experienced 242 total opioid-related overdose events (231 nonfatal, 11 fatal) in the year before or after delivery. The overall overdose rate was 8.0 per 100,000 person-days. Overdoses were lowest in the third trimester (3.3/100,000 person-days in the third trimester) and then increased in the postpartum period with the highest overdose rate 7–12 months after delivery (12.3/100,000 person-days). Overall, 64.3% of women with evidence of OUD in the year before delivery received any pharmacotherapy in the year before delivery. Women receiving pharmacotherapy had reduced overdose rates in the early postpartum period. CONCLUSION: Pregnant women in Massachusetts have high rates of OUD. The year after delivery is a vulnerable period for women with OUD. Additional longitudinal supports and interventions tailored to women in the first year postpartum are needed to prevent and reduce overdose events.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Overdose risk is highest 7-12 months post-delivery.
“and overdose risk is highest 7–12 months post-delivery [14].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
Mattick, R. P., Breen, C. L., Kimber, J., & Davoli, M. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002207.pub4 · Cited by 2,312 · see citing works
Increases in drug and opioid-involved overdose deaths – United States, 2010-2015
Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm655051e1 · Cited by 2,194 · see citing works
Increases in drug and opioid overdose deaths — United States, 2000–2014
Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6450a3 · Cited by 1,859 · see citing works
Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L., Ferri, M., & Pastor-Barriuso, R. (2017) · BMJ · doi:10.1136/bmj.j1550 · Cited by 1,816 · see citing works
The Changing Face of Heroin Use in the United States
Cicero, T. J., Ellis, M. S., Surratt, H. L., & Kurtz, S. P. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.366 · Cited by 1,169 · see citing works
Kotelchuck, M. (1994) · American Journal of Public Health · doi:10.2105/ajph.84.9.1414 · Cited by 1,167 · see citing works
Committee Opinion No. 711: Opioid Use and Opioid Use Disorder in Pregnancy
(2017) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000002235 · Cited by 674 · see citing works
Vital Signs: Demographic and Substance Use Trends Among Heroin Users - United States, 2002-2013.
Jones, C. M., Logan, J. E., Gladden, R. M., & Bohm, M. K. (2015) · PubMed Central · Cited by 476 · see citing works
Opioid Abuse and Dependence during Pregnancy: Temporal Trends and Obstetrical Outcomes
Maeda, A., Bateman, B. T., Clancy, C. R., Creanga, A. A., & Leffert, L. R. (2014) · Anesthesiology · doi:10.1097/aln.0000000000000472 · Cited by 317 · see citing works
O’Donnell, J. K., Gladden, R. M., & Seth, P. (2017) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6634a2 · Cited by 311 · see citing works
Characteristics of Fentanyl Overdose — Massachusetts, 2014–2016
Somerville, N. J., O’Donnell, J. K., Gladden, R. M., Zibbell, J. E., Green, T. C., Younkin, M., Ruiz, S., Babakhanlou‐Chase, H., Chan, M., Callis, B. P., et al. (2017) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6614a2 · Cited by 291 · see citing works
Self-citationZedler, B. K., Mann, A. L., Kim, M., Amick, H. R., Joyce, A. R., Murrelle, E. L., & Jones, H. E. (2016) · Addiction · doi:10.1111/add.13462 · Cited by 240 · see citing works
Maternal Deaths From Suicide and Overdose in Colorado, 2004–2012
Metz, T. D., Rovner, P., Hoffman, M. C., Allshouse, A. A., Beckwith, K. M., & Binswanger, I. A. (2016) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000001695 · Cited by 204 · see citing works
Klaman, S. L., Isaacs, K. R., Leopold, A., Perpich, J., Hayashi, S., Vender, J., Campopiano, M., & Jones, H. E. (2017) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000308 · Cited by 197 · see citing works
Perinatal substance use: a prospective evaluation of abstinence and relapse
Forray, A., Merry, B., Lin, H., Ruger, J. P., & Yonkers, K. A. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.02.027 · Cited by 182 · see citing works
Substance Use in the Perinatal Period
Forray, A., & Foster, D. W. (2015) · Current Psychiatry Reports · doi:10.1007/s11920-015-0626-5 · Cited by 172 · see citing works
Postpartum Substance Use and Depressive Symptoms: A Review
Chapman, S. L. C., & Wu, L.-T. (2013) · Women & Health · doi:10.1080/03630242.2013.804025 · Cited by 125 · see citing works
Wilder, C., Lewis, D., & Winhusen, T. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.02.012 · Cited by 109 · see citing works
No. 349-Substance Use in Pregnancy
Ordean, A., Wong, S., & Graves, L. E. (2017) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2017.04.028 · Cited by 103 · see citing works
Benningfield, M. M., Dietrich, M. S., Jones, H. E., Kaltenbach, K., Heil, S. H., Stine, S. M., Coyle, M. G., Arria, A. M., O'Grady, K. E., Fischer, G., et al. (2012) · Addiction · doi:10.1111/j.1360-0443.2012.04041.x · Cited by 60 · see citing works
Drug-induced deaths - United States, 1999-2010.
Mack, K. A. (2013) · PubMed · Cited by 51 · see citing works
Kozhimannil, K. B., Graves, A. J., Jarlenski, M., Kennedy‐Hendricks, A., Gollust, S. E., & Barry, C. L. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.01.003 · Cited by 40 · see citing works
Peles, E., Schreiber, S., Bloch, M., Dollberg, S., & Adelson, M. (2011) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e318229bb25 · Cited by 28 · see citing works
Postpartum changes in methadone maintenance dose
Pace, C. A., Kaminetzky, L. B., Winter, M. R., Cheng, D. M., Saia, K., Samet, J. H., & Walley, A. Y. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.04.004 · Cited by 21 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [7]Hogan L Rutherford BK Schrader DR MARYLAND MATERNAL MORTALITY REVIEW 2016 ANNUAL REPORT Health – General Article 13-1203—1207
- [8]Kavanaugh V Pregnancy-Associated Deaths From Drug Overdose in Virginia, 1999–2007: A Report from the Virginia Maternal Mortality Review Team 2015
Cited by
Sorted by citations
Maternal self-harm deaths: an unrecognized and preventable outcome
Mangla, K., Hoffman, M. C., Trumpff, C., O’Grady, S., & Monk, C. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.02.056 · Cited by 215 · see citing works
Pregnancy-Associated Deaths Due to Drugs, Suicide, and Homicide in the United States, 2010–2019
Margerison, C. E., Roberts, M. H., Gemmill, A., & Goldman-Mellor, S. (2022) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000004649 · Cited by 142 · see citing works
Methadone and buprenorphine discontinuation among postpartum women with opioid use disorder
Schiff, D. M., Nielsen, T. C., Hoeppner, B. B., Terplan, M., Hadland, S. E., Bernson, D., Greenfield, S. F., Bernstein, J., Bharel, M., Reddy, J., et al. (2021) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2021.04.210 · Cited by 69 · see citing works
Self-citationGlazer, K. B., & Howell, E. A. (2021) · Archives of Women's Mental Health · doi:10.1007/s00737-021-01161-0 · Cited by 53 · see citing works
Shen, Y., Lo-Ciganic, W.-H., Segal, R., & Goodin, A. J. (2021) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2020.1727882 · Cited by 38 · see citing works
Burke, L. G., Zhou, X., Boyle, K. L., Orav, E. J., Bernson, D., Hood, M., Land, T., Bharel, M., & Frakt, A. B. (2020) · Addiction · doi:10.1111/add.14867 · Cited by 35 · see citing works
Self-citationNillni, 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
Non-Obstetric Maternal Mortality Trends by Race in the United States
Huang, R. S., Spence, A. R., & Abenhaim, H. A. (2024) · Maternal and Child Health Journal · doi:10.1007/s10995-023-03862-7 · Cited by 13 · see citing works
- Authors
- Schiff, D. M., Nielsen, T., Terplan, M., Hood, M., Bernson, D., Diop, H., Bharel, M., Wilens, T. E., LaRochelle, M., Walley, A. Y., & Land, T.
- Affiliations
- Boston Medical Center (US)
- ORCID
- Venue
- Obstetrics & Gynecology
- Published
- 2018-08
- Volume
- 132
- Issue
- 2
- Pages
- 466-474
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC6060005
- OpenAlex
- W2876455145
- Cited by
- 327
- References
- 24
- Citations by year
- 2026: 33 · 2025: 39 · 2024: 38 · 2023: 59 · 2022: 36 · 2021: 55 · 2020: 39 · 2019: 26 · 2018: 2
- FWCI
- 29.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K23DA042168)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid overdose, opioid use disorder, pregnancy, postpartum period, maternal health, methadone, buprenorphine, opioid therapy, overdose prevention
- MeSH terms
- Adult, Buprenorphine, Female, Humans, Massachusetts, Methadone, Opioid-Related Disorders, Pregnancy, Pregnancy Complications, Puerperal Disorders, Retrospective Studies, Opiate Substitution Treatment, Drug Overdose
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
