Relationship between opioid use disorder during pregnancy, delivery-related outcomes, and healthcare utilization in Michigan Medicaid, 2012–2021

0 PSYCHOLOGY, CLINICAL

Journal of substance use and addiction treatment Pub Date : 2025-05-04 DOI:10.1016/j.josat.2025.209720

Clayton J. Shuman , Xiaosong Zhang , Stephanie V. Hall , Anca Tilea , Sarah J. Clark , Ashlee J. Vance , Anna Courant , Kara Zivin

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引用次数: 0

Abstract

Introduction

Pregnant individuals with opioid use disorder (OUD) deliver >20,000 infants annually in the United States, with serious health consequences for perinatal individuals and their infants. This study compares delivery-related outcomes and healthcare utilization among Michigan Medicaid-enrolled perinatal individuals with and without an OUD diagnosis.

Methods

We conducted a retrospective cohort study among Michigan Medicaid enrollees aged 15–44 who delivered a live infant between 2012 and 2021.

Results

The cohort included 218,890 deliveries among 170,002 individuals enrolled continuously in Michigan Medicaid for nine months before delivery and up to three months postpartum. Of those, 3.26 % had an OUD diagnosis during this analytic period. Perinatal individuals with OUD identified primarily as White (82.9 %), lived in urban areas (77.2 %), and had a lower income (68.6 %). Among individuals with OUD, 31 % had another behavioral health diagnosis and 55.1 % received a prescription for a psychotropic medication. Of those with OUD, 47.4 % received a prescription for medication for OUD. Deliveries with OUD versus without OUD had a lower probability of cesarean delivery (aOR = 0.89) but higher odds of preterm delivery (aOR = 1.31). Those with OUD had higher likelihood of ambulatory (aOR = 1.99), ED/observational (aOR = 1.19), psychotherapy (aOR = 5.48), and substance use disorder care (aOR = 27.05) visits than those without OUD.

Conclusions

Medicaid-enrolled perinatal individuals in Michigan with OUD had higher rates of preterm birth and healthcare utilization compared to those without OUD. Clinicians and policymakers should target early detection and tailored, coordinated treatment to better address the needs of these individuals.

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2012-2021年密歇根医疗补助计划中怀孕期间阿片类药物使用障碍、分娩相关结局和医疗保健利用之间的关系

在美国，患有阿片类药物使用障碍（OUD）的孕妇每年分娩20,000名婴儿，对围产期个体及其婴儿造成严重的健康后果。本研究比较了密歇根医疗补助登记的围产期个体有和没有OUD诊断的分娩相关结果和医疗保健利用情况。方法：我们对2012年至2021年间分娩一名活婴的15-44岁密歇根医疗补助参保者进行了回顾性队列研究。结果该队列包括218,890例分娩，在密歇根州医疗补助计划连续登记的170,002人中，分娩前9个月至产后3个月。其中，3.26%的人在分析期间被诊断为OUD。围产期OUD患者主要为白人（82.9%），居住在城市地区（77.2%），收入较低（68.6%）。在OUD患者中，31%的人有其他行为健康诊断，55.1%的人接受过精神药物的处方。在患有OUD的患者中，47.4%的人接受了OUD的药物处方。有OUD的分娩与无OUD的分娩相比，剖宫产的可能性较低（aOR = 0.89），但早产的可能性较高（aOR = 1.31）。与没有OUD的患者相比，OUD患者有更高的可能性进行门诊（aOR = 1.99）、ED/观察（aOR = 1.19）、心理治疗（aOR = 5.48）和物质使用障碍护理（aOR = 27.05）。结论在密歇根州，与没有OUD的围产期个体相比，医疗补助登记的OUD患者的早产率和医疗保健利用率更高。临床医生和政策制定者应该针对早期发现和量身定制的协调治疗，以更好地满足这些个体的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)

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