Opioid use among patients seeking pregnancy-related care at Pennsylvania hospitals has risen significantly since 2000, according to new data published by the Pennsylvania Health Care Cost Containment Council (PHC4).
The research brief, published this week, showed that opioid use was present in one in every 51 maternal hospital stays — hospital visits for deliveries or other pregnancy-related issues — in the state in 2016 and 2017. Between 2000 and 2001, that rate was just one in 329.
Opioids were the most common drug present, but hospital data didn’t specify how many of those patients were using the medicines under doctors' orders. Because entering withdrawal during pregnancy can cause a miscarriage, pregnant women with opioid use disorder are often prescribed opioid-based addiction treatments like methadone or buprenorphine to take during their pregnancy.
Opioid use during pregnancy is a source of significant controversy around the country. In September, the Pennsylvania Supreme Court heard arguments in a case where a woman who tested positive for opioids, marijuana, and anti-anxiety drugs was accused of child abuse, and lost custody of her newborn. The court has not ruled on whether prenatal drug use can be deemed child abuse.
Last year, nearly 3,300 babies in Pennsylvania were born exposed to opioids, or 2 percent of all births in the state. Health officials and politicians have paid particular attention to the issue. In October, first lady Melania Trump visited Thomas Jefferson University Hospital’s treatment program for mothers with addiction, which has been operating for 45 years and recently opened a residential treatment facility.
The PHC4 study found that maternal hospital stays where opioid use was present were also more likely to see a host of co-occurring conditions, including tobacco and other substance use, hepatitis C infections, and mental health disorders, as well as false or pre-term labor and slowed fetal growth.
And, the study found, nearly 48 percent of deliveries involving maternal opioid use were premature or early-term, compared with 33 percent of deliveries that did not involve opioid use.
Elk County, in western Pennsylvania, had the highest rate of opioid use per maternal hospital stays, with opioid use present in 75.8 out of every 1,000 maternal hospital stays. Opioid use was present in 23 out of every 1,000 maternal hospital stays in Philadelphia.
Opioid use was nearly twice as likely to be present at maternal hospital stays in high-poverty areas, and opioid use was more likely among white patients on maternal hospital stays than black or Hispanic patients.