Multilevel Factors Associated With Hospitalizations in the First-Year Postpartum Among Persons With Opioid Use...

Area of Science:

• Public Health
• Addiction Medicine
• Perinatal Health

Background:

• The postpartum period presents unique challenges for individuals with opioid use disorder (OUD), including increased risk of health and drug-related problems due to new responsibilities and changing environments.
• This study investigates factors contributing to hospitalization among individuals with OUD during their first year postpartum.

Purpose of the Study:

• To examine county-level and individual-level factors associated with hospitalization in the first year postpartum among individuals with OUD.
• To identify specific risk factors for all-cause, OUD-related, and mental health-related hospitalizations in early and late postpartum periods.

Main Methods:

• A cohort of 1966 individuals with OUD at delivery in Pennsylvania was analyzed using hospital discharge data.
• Multilevel logistic regression models assessed county-level factors (income, rurality, jail rate, OUD treatment facilities, hospital beds) and individual-level factors (demographics, insurance, substance use, mental health conditions).

Main Results:

• 14% (n=280) of individuals experienced at least one hospitalization in the first year postpartum.
• Higher county densities of OUD treatment facilities were associated with significantly lower odds of all hospitalization types in early postpartum (0-42 days), particularly OUD-related hospitalizations.
• Younger maternal age and prior early postpartum hospitalizations were associated with increased odds of later hospitalizations, including mental health-related events.

Conclusions:

• County-level healthcare and drug treatment systems play a significant role in hospitalizations among individuals with OUD postpartum.
• Addressing systemic barriers to accessing OUD treatment and postpartum care is crucial for improving health outcomes and reducing drug-related harms for this population.