Adverse Pregnancy Outcomes with Co-Occurring Opioid and Stimulant Use Disorders

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Addiction Medicine

Background:

• Substance use disorder (SUD) in pregnancy complicates maternal and neonatal health.
• Polysubstance use, particularly opioids and stimulants, is a growing concern.
• Understanding the impact of co-occurring SUDs on pregnancy is crucial for public health.

Purpose of the Study:

• To evaluate the association between co-occurring opioid and stimulant use disorder and adverse pregnancy outcomes (APOs).
• To compare the risk of APOs in pregnant individuals with co-occurring opioid and stimulant use disorder versus those with single substance use disorders.

Main Methods:

• Cross-sectional analysis of inpatient delivery admissions (2016-2020) from the HCUP NIS.
• ICD-10 codes used to identify opioid use disorder, stimulant use disorder, and APOs.
• Multivariable logistic regression adjusted for sociodemographic factors.

Main Results:

• Co-occurring opioid and stimulant use disorder was associated with the highest prevalence of APOs (54.6%).
• This dual diagnosis was an independent predictor of APOs (aOR 3.65), exceeding risks from single SUDs.
• Rates of APOs increased across all groups over the study period.

Conclusions:

• Co-occurring opioid and stimulant use disorder presents the greatest risk for adverse pregnancy outcomes.
• This dual diagnosis is an independent predictor of APOs, even after accounting for sociodemographic variables.
• Targeted interventions for pregnant individuals with co-occurring SUDs are warranted.