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Trends in Prenatal Opioid Use Disorder in California, 2010-2022
Sidra Goldman-Mellor1, Jyotishman Pathak2, Claire Margerison3
1Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, California; Health Sciences Research Institute, University of California, Merced, Merced, California.
American Journal of Preventive Medicine
|September 8, 2025
Summary
The prevalence of prenatal opioid use disorder doubled in California between 2010 and 2022, but most of the increase occurred before fentanyl
Area of Science:
- Perinatal Health
- Public Health
- Epidemiology
Background:
- Opioid-related deaths in perinatal populations have risen sharply in the U.S.
- The impact of illicit fentanyl on prenatal opioid use disorder is largely unknown.
- California experienced a later influx of fentanyl starting in 2019.
Purpose of the Study:
- To investigate the association between California's fentanyl influx and prenatal opioid use disorder.
- To analyze trends in opioid use disorder among pregnant individuals in California.
Main Methods:
- Ecologic, repeated retrospective cohort study of California live-birth deliveries (2010-2022).
- Utilized statewide, all-payer linked hospitalization and emergency department records.
- Examined prenatal opioid use disorder prevalence using ICD-9-CM/ICD-10-CM diagnoses and joinpoint/logistic regression.
Main Results:
- Prenatal opioid use disorder prevalence doubled from 2010-2022 (0.15%-0.30% at delivery; 0.04%-0.08% via ED visits).
- The majority of the increase occurred before 2018; post-2018 changes were minimal.
- Disparities in prevalence were noted among non-Hispanic White, other/multiple race individuals, and Medicaid beneficiaries.
Conclusions:
- Fentanyl's introduction in California was linked to only minor increases in prenatal opioid use disorder.
- Ongoing monitoring of these trends is crucial for safeguarding perinatal health.
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