Predictors of Opioid Misuse and Abuse Among Pregnant Women in the US

Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of past-year misuse, past-month misuse, and past-year opioid abuse were 5.2%,1.0%, and 0.9%, respectively. Older age and higher household income were protective against past-year misuse. The odds of past-year misuse were lower for pregnant women in their third trimester. Non-Hispanic Black Americans and Hispanics had lower odds of past-year misuse compared to non-Hispanic Whites. However, Non-Hispanic Native Hawaiian /Other Pacific Islanders reported higher odds of past-year misuse; yet lower sample sizes of minority groups may have affected the findings. Good health and excellent health status were protective against past-year misuse. Older age was protective against past-month misuse. Lower odds of past-year opioid abuse were observed in non-Hispanic Black women compared to non-Hispanic White women.

The findings underscore the need for interventions targeting younger pregnant women, women in early pregnancy, from low-income households, who are non-Hispanic Native Hawaiian /Other Pacific Islanders, and women with poor health to mitigate adverse maternal and fetal outcomes.