{"title":"Trends in Prenatal Opioid Use Disorder in California, 2010–2022","authors":"Sidra Goldman-Mellor PhD , Jyotishman Pathak PhD , Claire E. Margerison PhD","doi":"10.1016/j.amepre.2025.108086","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid-related deaths among perinatal populations have increased sharply in the U.S. Whether the recent ascendance of illicit fentanyl and other synthetic opioids in the drug supply translates to an increase in prenatal opioid use disorder remains unknown. This study investigated whether California’s comparatively late fentanyl influx, in 2019, was associated with a subsequent increase in opioid use disorder among pregnant people.</div></div><div><h3>Methods</h3><div>This ecologic, repeated retrospective cohort study examined annual cohorts of individuals with an index live-birth delivery in California from 2010 to 2022. Analyses used statewide, all-payer linked hospitalization and emergency department records. Overall and subgroup-specific trends in the prevalence of prenatal opioid use disorder, assessed using International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-10-CM diagnoses recorded at delivery hospitalization and during prenatal emergency department visits, were examined using joinpoint and logistic regression analyses. Data analysis was conducted in 2025.</div></div><div><h3>Results</h3><div>The study included 4,381,064 index deliveries. Between 2010 and 2022, the prevalence of prenatal opioid use disorder doubled (as assessed at delivery: 0.15%–0.30%; as assessed via prenatal opioid use disorder emergency department visits: 0.04%–0.08%). Joinpoint analysis indicated that most of this increase occurred before 2018, with annual percentage changes after 2018 being largely flat (annual percentage change in at-delivery prevalence, 2.4% [95% CI= −2.2%, 7.3%]; annual percentage change in emergency department visit prevalence, 1.4% [95% CI= −7.0%, 3.8%]). Differences in the 2019–2022 versus 2010–2018 prevalence of prenatal opioid use disorder were larger among non-Hispanic White and other/multiple race individuals, as well as those covered by Medicaid.</div></div><div><h3>Conclusions</h3><div>The recent introduction of fentanyl to California was associated with only incremental increases in the prevalence of prenatal opioid use disorder. Continued tracking of these trends is important for perinatal health.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108086"},"PeriodicalIF":4.5000,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0749379725005549","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Opioid-related deaths among perinatal populations have increased sharply in the U.S. Whether the recent ascendance of illicit fentanyl and other synthetic opioids in the drug supply translates to an increase in prenatal opioid use disorder remains unknown. This study investigated whether California’s comparatively late fentanyl influx, in 2019, was associated with a subsequent increase in opioid use disorder among pregnant people.
Methods
This ecologic, repeated retrospective cohort study examined annual cohorts of individuals with an index live-birth delivery in California from 2010 to 2022. Analyses used statewide, all-payer linked hospitalization and emergency department records. Overall and subgroup-specific trends in the prevalence of prenatal opioid use disorder, assessed using International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-10-CM diagnoses recorded at delivery hospitalization and during prenatal emergency department visits, were examined using joinpoint and logistic regression analyses. Data analysis was conducted in 2025.
Results
The study included 4,381,064 index deliveries. Between 2010 and 2022, the prevalence of prenatal opioid use disorder doubled (as assessed at delivery: 0.15%–0.30%; as assessed via prenatal opioid use disorder emergency department visits: 0.04%–0.08%). Joinpoint analysis indicated that most of this increase occurred before 2018, with annual percentage changes after 2018 being largely flat (annual percentage change in at-delivery prevalence, 2.4% [95% CI= −2.2%, 7.3%]; annual percentage change in emergency department visit prevalence, 1.4% [95% CI= −7.0%, 3.8%]). Differences in the 2019–2022 versus 2010–2018 prevalence of prenatal opioid use disorder were larger among non-Hispanic White and other/multiple race individuals, as well as those covered by Medicaid.
Conclusions
The recent introduction of fentanyl to California was associated with only incremental increases in the prevalence of prenatal opioid use disorder. Continued tracking of these trends is important for perinatal health.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.