Perinatal Opioid Use Disorder Research, Race, and Racism: A Scoping Review

Area of Science:

• Perinatal Health
• Health Equity Research
• Substance Use Disorders

Background:

• Racial and ethnic inequities are prevalent in maternal-infant health and substance use disorder treatment.
• Opioid use disorder (OUD) in pregnant individuals and its impact on infants present significant public health challenges.
• Understanding disparities in care and outcomes is crucial for addressing these inequities.

Purpose of the Study:

• To systematically review research on maternal-infant dyads affected by OUD.
• To evaluate racial/ethnic disparities in health utilization and outcomes.
• To critically assess the reporting and inclusion of race/ethnicity data in OUD research.

Main Methods:

• Systematic review of peer-reviewed literature from MEDLINE, Embase, and Web of Science (2000-2020).
• Included studies reporting health utilization and outcomes for dyads affected by OUD from pregnancy through the infant's first birthday.
• Extracted data on race/ethnicity, study exposures/outcomes, data analysis, and discussion of findings related to race/ethnicity and racism.

Main Results:

• Of 2023 articles reviewed, 152 quantitative and 17 qualitative studies were included.
• Few studies (3/152 quantitative) explicitly evaluated racial/ethnic differences among dyads.
• Race/ethnicity data were poorly reported; many studies mentioned race/ethnicity but few analyzed or adjusted for it, and none discussed racism's role.

Conclusions:

• Few studies are designed to evaluate racial/ethnic inequities in perinatal OUD.
• Inadequate reporting and analysis of race/ethnicity data impede understanding of disparities.
• Prioritizing inclusion of marginalized groups and addressing structural racism is essential for achieving health equity in perinatal OUD care.