Title

Maternal opioid use disorder at delivery hospitalization in a rural state: Maine, 2009-2018.

Authors

Sarah M.B. Gabrielson
Jenny L. Carwile, Maine Medical Center
A. B. O'Connor, Maine General Medical Center
Katherine A. Ahrens PhD, University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research CenterFollow

Document Type

Article

Publication Date

2-14-2020

Keywords

rural health, MRHRC, opioid use disorder, substance use, rural, Maine, hospitalizaton

Publication Title

Public Health

Abstract

OBJECTIVES: A multistate analysis found Maine had the second highest average annual increase in maternal opioid use disorder (OUD) at delivery hospitalization during 1999-2012. The objective of our analysis was to estimate the prevalence, maternal characteristics, and geographic distribution of OUD at delivery hospitalization in Maine using recent state-level data.

STUDY DESIGN: Serially collected cross-sectional population-based data.

METHODS: We used diagnosis and procedure codes to identify deliveries among hospital discharges in Maine, 2009-2018 (n = 120,764), and to categorize deliveries according to the prevalence of maternal OUD and selected conditions. We assessed linear trends in OUD at delivery and calculated prevalence ratios (PR) for co-occurring maternal conditions.

RESULTS: The prevalence of maternal OUD per 1000 deliveries in Maine increased from 22.7 in 2009 to 34.9 in 2018 (linear trend P value < 0.01), with a mean annual increase of 1.6 (95% confidence interval [CI]: 0.9 to 2.4). The following conditions were more prevalent among women with OUD at delivery: hepatitis C, PR = 45.8 (95% CI: 38.8 to 54.2); other drug abuse or dependence, PR = 16.8 (13.4 to 20.9); alcohol abuse and dependence, PR = 8.5 (5.8 to 12.5); nicotine use, PR = 6.0 (5.9 to 6.2); cannabis use, PR = 5.2 (4.6 to 5.9); anxiety, PR = 2.7 (2.5 to 3.2); and depression, PR = 2.7 (2.4 to 3.1). Women with OUD at delivery were also more likely to reside in small rural areas (27.3% vs 22.5%) and deliver in a hospital with a level III nursery (50.6% vs 34.9%).

CONCLUSIONS: Maternal OUD now accounts for 1 in 29 deliveries in Maine and commonly occurs with other medical conditions. Prevention and treatment of OUD among reproductive age women in Maine remains needed.

Comments

Correspondence: Katherine Ahrens, PhD, katherine.ahrens@maine.edu

Recommended Citation

Gabrielson, S. M. B., Carwile, J. L., O'Connor, A. B., & Ahrens, K. A. (2020). Maternal opioid use disorder at delivery hospitalization in a rural state: Maine, 2009-2018. Public Health,181,171-179. doi:10.1016/j.puhe.2019.12.014