Opioid use in pregnancy has more than doubled in California
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The rate of opioid use in pregnancy more than doubled over the past decade, a new Oregon Health & Science University study using California hospital data found.
Why it matters: Researchers warn the sharp rise puts both mothers and babies at risk — increasing the chance for negative complications such as hypertension, respiratory distress, preterm birth, infant withdrawal syndrome and death.
The big picture: The data, collected between 2008 and 2020, likely underestimates today's danger as the opioid crisis has since worsened in many parts across the country. That includes in San Francisco, where accidental drug overdose deaths have spiked since the pandemic.
- "The real situation is more dire and more severe," Jaime Lo, an associate professor of obstetrics and gynecology at OHSU and the study's lead author, told Axios.
What they did: Hoping to better understand the prevalence of opioid use in pregnancy and its potential health outcomes, researchers analyzed hospital data encompassing more than 5.5 million patients in California over the course of 12 years.
- Lo said her team zeroed in on the state due to its diverse age, racial and ethnic demographic makeup, which makes the study's findings "more representative" of the broader U.S. population.
By the numbers: OHSU's analysis found the prevalence of an opioid-related diagnosis in pregnancy rose from 0.14% in 2008 to 0.33% in 2020 — from roughly 700 patients to nearly 1,200, respectively.
State of play: Lo said outcomes for pregnant patients with opioid use disorder and babies remain poor because of the lack of widespread multidisciplinary care — like medication-assisted treatment, mental health support and coordinated obstetric and pediatric services.
- Provider stigma, referral barriers and a shortage of clinicians trained in both addiction medicine and pregnancy care mean patients can often fall through the cracks, she added.
Zoom in: San Francisco offers several programs aimed at reducing stigma around opioid use in pregnancy and ensuring access to treatment.
- Team Lily, a project of the Zuckerberg San Francisco General Hospital, operates a clinic that provides prenatal care, medication for opioid use and case management services.
- The city's public health department also runs a perinatal stabilization program that supports pregnant women experiencing homelessness, addiction or mental health disorders via home visits and tailored treatment plans.
The bottom line: Rising rates aren't irreversible. Outcomes can improve when medical systems invest in perinatal addiction programs, Lo said.
- "That's how we can really turn this conversation around and start to see some of those numbers that are rising turn the other way."