Prenatal opioid use as a predictor of postpartum suicide attempts among reproductive-age women enrolled in Oregon...

Area of Science:

• Reproductive Health
• Maternal Mental Health
• Addiction Medicine

Background:

• Rising rates of suicide and opioid use disorder (OUD) in pregnant and postpartum women highlight an urgent public health concern.
• Medicaid-enrolled perinatal women are a key demographic experiencing increasing rates of OUD and suicide attempts.

Purpose of the Study:

• To characterize OUD and suicide attempts among Medicaid-enrolled perinatal women.
• To examine prenatal OUD diagnosis as a predictive marker for postpartum suicide attempts.

Main Methods:

• Linked data from Oregon birth certificates, Medicaid files, and hospital records (N=61,481).
• Analyzed suicide attempts (any means, opioid poisoning) and OUD diagnoses during pregnancy and postpartum.
• Utilized probit and simultaneous equations models to assess the relationship between prenatal OUD and postpartum suicide attempts, mediated by postpartum OUD.

Main Results:

• Postpartum suicide attempts occurred at a rate of 94.3 per 100,000, with 79% involving opioid poisoning.
• Prenatal OUD diagnosis was associated with a three-fold increased risk of postpartum suicide attempts by opioid poisoning.
• A prenatal OUD diagnosis significantly elevated the risk of postpartum suicide attempts by opioid poisoning, mediated by postpartum OUD diagnosis.

Conclusions:

• Medicaid-enrolled women of reproductive age face elevated suicide attempt risks, especially involving opioid poisoning, during pregnancy and postpartum.
• Prenatal OUD diagnosis serves as a critical indicator for increased risk of postpartum suicide attempts involving opioid poisoning.