Perinatal Substance Use and Factors Associated With Maternal and Neonatal Morbidity and Mortality

Area of Science:

• Perinatal health
• Substance use disorders
• Public health

Background:

• Pregnant individuals with substance use disorders (PSUD) face significant barriers to accessing essential healthcare services.
• Limited data exists regarding the specific maternal and neonatal health outcomes for this population.
• Understanding associated factors is critical for improving care and outcomes.

Purpose of the Study:

• To determine the association between clinical and demographic factors and maternal/neonatal morbidity and mortality in people with PSUD.
• To identify specific risk factors contributing to adverse outcomes in this high-risk group.
• To inform targeted interventions and improve healthcare delivery.

Main Methods:

• Population-based retrospective cohort study utilizing provincial health administrative data in British Columbia, Canada (2010-2021).
• Included all dyads with PSUD indicated within one year of prenatal care contact to delivery.
• Regression models were used to analyze sociodemographic, pregnancy, and clinical factors against maternal and neonatal morbidity and mortality outcomes.

Main Results:

• Individuals with PSUD exhibited 1.5 times higher maternal morbidity and over 2 times higher neonatal morbidity and mortality rates compared to the general BC population.
• Specific regions (Vancouver Coastal, Interior, Vancouver Island) were associated with increased odds of maternal and neonatal morbidity.
• An 11% annual increase in maternal mortality odds was observed over the study period.

Conclusions:

• People with PSUD face significantly elevated rates of maternal and neonatal morbidity and mortality.
• Regional disparities, substance use type, and demographic/clinical factors are independently linked to adverse maternal and neonatal outcomes.
• Enhanced integrated care models and robust health surveillance systems are urgently needed to mitigate these disparities.