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

Davida M Schiff1, Erin C Work1, Bridget Foley2

  • 1Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts.

Pediatrics
|February 14, 2022
PubMed

Insights

Racial and ethnic disparities persist in maternal-infant health and opioid use disorder (OUD) treatment. This review found poor reporting of race/ethnicity data, hindering efforts to achieve health equity for affected dyads.

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.
Abstract

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