{"title":"Trends in prenatal opioid use disorder in California, 2010-2022.","authors":"Sidra Goldman-Mellor, Jyotishman Pathak, Claire Margerison","doi":"10.1016/j.amepre.2025.108086","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Opioid-related deaths among perinatal populations have increased sharply in the United States. Whether the recent ascendence of illicit fentanyl and other synthetic opioids in the drug supply translates to increasing prenatal opioid use disorder (OUD) remains unknown. This study tested whether California's comparatively late fentanyl influx, in 2019, was associated with a subsequent increase in OUD among pregnant people.</p><p><strong>Methods: </strong>This ecologic, repeated retrospective cohort study examined annual cohorts of individuals with an index live-birth delivery in California, 2010-2022. Analyses used statewide, all-payer linked hospitalization and emergency department (ED) records. Overall and subgroup-specific trends in prevalence of prenatal OUD, assessed using ICD-9/10-CM diagnoses recorded at delivery hospitalization and during prenatal ED visits, were examined using joinpoint and logistic regression analyses. Data analysis was conducted in 2025.</p><p><strong>Results: </strong>The study included 4,381,064 index deliveries. Between 2010 and 2022, prevalence of prenatal OUD doubled (as assessed at delivery: 0.15% to 0.30%; as assessed via prenatal OUD ED visits: 0.04% to 0.08%). Joinpoint analysis indicated that most of this increase occurred prior to 2018; annual percentage changes (APC) after 2018 were largely flat (at-delivery prevalence APC: 2.4%, 95% CI, -2.2% to 7.3%; ED prevalence APC: 1.4%, 95% CI, -7.0% to 3.8%). Differences in 2019-2022 vs. 2010-2018 prevalence of prenatal OUD were larger among non-Hispanic White and other/multiple-race individuals, and those covered by Medicaid.</p><p><strong>Conclusions: </strong>The recent introduction of fentanyl to California was associated with only incremental increases in prevalence of prenatal OUD. Continued tracking of these trends is important for perinatal health.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"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://doi.org/10.1016/j.amepre.2025.108086","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 United States. Whether the recent ascendence of illicit fentanyl and other synthetic opioids in the drug supply translates to increasing prenatal opioid use disorder (OUD) remains unknown. This study tested whether California's comparatively late fentanyl influx, in 2019, was associated with a subsequent increase in OUD among pregnant people.
Methods: This ecologic, repeated retrospective cohort study examined annual cohorts of individuals with an index live-birth delivery in California, 2010-2022. Analyses used statewide, all-payer linked hospitalization and emergency department (ED) records. Overall and subgroup-specific trends in prevalence of prenatal OUD, assessed using ICD-9/10-CM diagnoses recorded at delivery hospitalization and during prenatal ED 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, prevalence of prenatal OUD doubled (as assessed at delivery: 0.15% to 0.30%; as assessed via prenatal OUD ED visits: 0.04% to 0.08%). Joinpoint analysis indicated that most of this increase occurred prior to 2018; annual percentage changes (APC) after 2018 were largely flat (at-delivery prevalence APC: 2.4%, 95% CI, -2.2% to 7.3%; ED prevalence APC: 1.4%, 95% CI, -7.0% to 3.8%). Differences in 2019-2022 vs. 2010-2018 prevalence of prenatal OUD were larger among non-Hispanic White and other/multiple-race individuals, and those covered by Medicaid.
Conclusions: The recent introduction of fentanyl to California was associated with only incremental increases in prevalence of prenatal OUD. 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.