Prenatal substance use in the rural and Appalachian state: Project WATCH study 2020-2022.
Appalachia
prenatal
rural
substance use
Journal
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
ISSN: 1748-0361
Titre abrégé: J Rural Health
Pays: England
ID NLM: 8508122
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
medline:
20
9
2023
pubmed:
25
2
2023
entrez:
24
2
2023
Statut:
ppublish
Résumé
To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV). Population-based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February 2020 and June 2022. A composite substance use variable included 9 categories: "no substance use," "opioids," "cannabis," "sedatives/hypnotics," "stimulants," "opioids and cannabis," "opioids and stimulants," "cannabis and stimulants," and "opioids, cannabis, and stimulants." These data were gathered through self-report, medical records, and/or positive drug screen at labor and delivery. 12.4% of women used one or more substances (opioids, cannabis, stimulants, and sedatives/hypnotics) during their current pregnancy. The mean age of women using cannabis was 25.34 (SD = 5.31), stimulants was 28.88 (SD = 5.62), and opioid was 30.19 (SD = 4.78). White women were more likely to use opioids (aOR = 2.19, 95% CI 1.46, 3.28) and less likely to use cannabis (aOR = 0.39, 95% CI 0.34, 0.44) compared to minority racial groups. Women with cannabis use were more likely to live in urban versus rural regions (aOR = 1.47, 95% CI 1.33, 1.62). The odds of using any type of substance(s) were significantly higher in women who smoked (aOR range 4.17-30.85), had Medicaid (aOR range 1.52-7.65), and those receiving inadequate prenatal care (aOR range 1.96-16.83). In this rural Appalachian state, 1 in 8 women used 1 or more substances (opioids, cannabis, stimulants, and/or sedatives/hypnotics) during pregnancy and the type of substance used varied by sociodemographic and health-related factors. These factors should inform state-level strategies and initiatives to address the substance use crisis for this population.
Substances chimiques
Analgesics, Opioid
0
Hypnotics and Sedatives
0
Central Nervous System Stimulants
0
Hallucinogens
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
804-815Informations de copyright
© 2023 National Rural Health Association.
Références
SAMHSA. 2020 National Survey of Drug Use and Health (NSDUH) Releases. https://www.samhsa.gov/data/release/2020-national-survey-drug-use-and-health-nsduh-releases Table 6.20B. 2020. Accessed Feb 16, 2023.
CDC. Polysubstance Use During Pregnancy. Pregnancy. Content Source. Centers for Disease Control and Prevention; 2022.
Blum RW, Beuhring T, Shew ML, Bearinger LH, Sieving RE, Resnick MD. The effects of race/ethnicity, income, and family structure on adolescent risk behaviors. Am J Public Health. 2000;90(12):1879-1884.
Schuler MS, Schell TL, Wong EC. Racial/ethnic differences in prescription opioid misuse and heroin use among a national sample, 1999-2018. Drug Alcohol Depend. 2021;221:108588.
Smid MC, Metz TD, Gordon AJ. Stimulant use in pregnancy: an under-recognized epidemic among pregnant women. Clin Obstet Gynecol. 2019;62(1):168-184.
Volkow ND, Han B, Compton WM, Blanco C. Marijuana use during stages of pregnancy in the United States. Ann Intern Med. 2017;166(10):763-764.
Admon LK, Bart G, Kozhimannil KB, Richardson CR, Dalton VK, Winkelman TNA. Amphetamine- and opioid-affected births: incidence, outcomes, and costs, United States, 2004-2015. Am J Public Health. 2019;109(1):148-154.
Hirai AH, Ko JY, Owens PL, Stocks C, Patrick SW. Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010-2017. JAMA. 2021;325(2):146-155.
Jarlenski MP, Paul NC, Krans EE. Polysubstance use among pregnant women with opioid use disorder in the United States, 2007-2016. Obstet Gynecol. 2020;136(3):556-564.
Ondocsin J, Mars SG, Howe M, Ciccarone D. Hostility, compassion and role reversal in West Virginia's long opioid overdose emergency. Harm Reduct J. 2020;17(1):74.
USCB. United States Census Bureau. https://www.census.gov/quickfacts/fact/table/WV,US/PST045221. 2022. Accessed Feb 16, 2023.
CDC. 2020 Drug Overdose Death Rates. https://www.cdc.gov/drugoverdose/deaths/2020.html. https://www.cdc.gov/drugoverdose/deaths/index.html. 2021. Accessed July 9, 2022.
Umer A, Loudin S, Maxwell S, et al. Capturing the statewide incidence of neonatal abstinence syndrome in real time: the West Virginia experience. Pediatr Res. 2019;85(5):607-611.
USDA. State Fact Sheet. West Virginia. https://data.ers.usda.gov/reports.aspx?StateFIPS=54&StateName=West%20Virginia&ID=17854. 2021. Accessed Feb 16, 2023.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). 2013.
Mullett MD, Britton CM, John C, Hamilton CW. WV Birth Score: maternal smoking and drugs of abuse. W V Med J. 2010;106(4):16-18.
Umer A, Lilly C, Hamilton C, et al. Updating a perinatal risk scoring system to predict infant mortality. Am J Perinatol. 2019;36(12):1278-1287.
Funai EF, White J, Lee MJ, Allen M, Kuczynski E. Compliance with prenatal care visits in substance abusers. J Matern Fetal Neonatal Med. 2003;14(5):329-332.
Stone R. Pregnant women and substance use: fear, stigma, and barriers to care. Health Justice. 2015;3(1):2.
Roberts SC, Pies C. Complex calculations: how drug use during pregnancy becomes a barrier to prenatal care. Matern Child Health J. 2011;15(3):333-341.
USDA. Rural-Urban Continuum Codes. US Department of Agriculture; 2020.
Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol. 2017;17(1):162.
Haight SC, King BA, Bombard JM, et al. Frequency of cannabis use during pregnancy and adverse infant outcomes, by cigarette smoking status - 8 PRAMS states, 2017. Drug Alcohol Depend. 2021;220:108507.
van Gelder MM, Reefhuis J, Caton AR, et al. Characteristics of pregnant illicit drug users and associations between cannabis use and perinatal outcome in a population-based study. Drug Alcohol Depend. 2010;109(1-3):243-247.
Desai RJ, Hernandez-Diaz S, Bateman BT, Huybrechts KF. Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstet Gynecol. 2014;123(5):997-1002.
Ahrens KA, McBride CA, O'Connor A, Meyer MC. Medication for addiction treatment and postpartum health care utilization among pregnant persons with opioid use disorder. J Addict Med. 2022;16(1):56-64.
Krans EE, Kim JY, James AE 3rd, Kelley D, Jarlenski MP. Medication-assisted treatment use among pregnant women with opioid use disorder. Obstet Gynecol. 2019;133(5):943-951.
Gao YA, Drake C, Krans EE, Chen Q, Jarlenski MP. Explaining racial-ethnic disparities in the receipt of medication for opioid use disorder during pregnancy. J Addict Med. 2022;16(6):e356-e365.
Schiff DM, Nielsen T, Hoeppner BB, et al. Assessment of racial and ethnic disparities in the use of medication to treat opioid use disorder among pregnant women in Massachusetts. JAMA Netw Open. 2020;3(5):e205734.
Hirsh AT, Anastas TM, Miller MM, Quinn PD, Kroenke K. Patient race and opioid misuse history influence provider risk perceptions for future opioid-related problems. Am Psychol. 2020;75(6):784-795.
Neighbors CJ, Choi S, Healy S, Yerneni R, Sun T, Shapoval L. Age related medication for addiction treatment (MAT) use for opioid use disorder among Medicaid-insured patients in New York. Subst Abuse Treat Prev Policy. 2019;14(1):28.
Skelton KR, Benjamin-Neelon SE. Characteristics associated with prenatal cannabis use vary with legality of recreational cannabis. J Womens Health (Larchmt). 2021;30(11):1565-1572.
Grywacheski V, Ali J, Baker MM, Gheorghe M, Wong SL, Orpana HM. Opioid and cannabis use during pregnancy and breastfeeding in relation to sociodemographics and mental health status: a descriptive study. J Obstet Gynaecol Can. 2021;43(3):329-336.
US Census. Census Bureau QuickFacts: United States [Internet]. https://www.census.gov/quickfacts/fact/table/WV,US/PST045221. 2021. Accessed Feb 16, 2023.
McCann A. Most and Least Educated States in America. https://wallethub.com/edu/e/most-educated-states/31075. 2022. Accessed Feb 16, 2023.
Kozhimannil K, Henning-Smith C, Chantarat T, Ecklund A, Jones C. Non-Medical Opioid Use among Rural and Urban Pregnant Women, 2007-2014. http://rhrc.umn.edu/wp-content/files_mf/1534866714UMNpolicybriefnonmedicalopioiduse.pdf. 2018. Accessed Feb 16, 2023.
Umer A, Lilly C, Hamilton C, et al. Disparities in neonatal abstinence syndrome and health insurance status: a statewide study using non-claims real-time surveillance data. Paediatr Perinat Epidemiol. 2021;35(3):330-338.
Medicaid. Percentage of Population Enrolled in Medicaid or CHIP by State. Centers for Medicare & Medicaid Services; 2020.
Good MM, Solt I, Acuna JG, Rotmensch S, Kim MJ. Methamphetamine use during pregnancy: maternal and neonatal implications. Obstet Gynecol. 2010;116(2):330-334.
Faherty LJ, Stein BD, Terplan M. Consensus guidelines and state policies: the gap between principle and practice at the intersection of substance use and pregnancy. Am J Obstet Gynecol MFM. 2020;2(3):100137.
Young-Wolff KC, Tucker LY, Armstrong MA, Conway A, Weisner C, Goler N. Correlates of pregnant women's participation in a substance use assessment and counseling intervention integrated into prenatal care. Matern Child Health J. 2020;24(4):423-431.
Vallejo MC, Shapiro RE, Lippy MW, Lilly CL, Brancazio LR. Independent risk factors for chronic illicit substance use during pregnancy. J Opioid Manag. 2020;16(5):351-356.
BRFSS. Map of Current Cigarette Use Among Adult. Current Cigarette Use Among Adults (Behavior Risk Factor Surveillance System). CDC; 2019.
Oga EA, Mark K, Coleman-Cowger VH. Cigarette smoking status and substance use in pregnancy. Matern Child Health J. 2018;22(10):1477-1483.
Rigg KK, Monnat SM. Urban vs. rural differences in prescription opioid misuse among adults in the United States: informing region specific drug policies and interventions. Int J Drug Policy. 2015;26(5):484-491.
Mack KA, Jones CM, Ballesteros MF. Illicit drug use, illicit drug use disorders, and drug overdose deaths in metropolitan and nonmetropolitan areas - United States. MMWR Surveill Summ. 2017;66(19):1-12.
Rural Health Information Hub. Results from the 2020 National Survey on Drug Use and Health: Detailed Tables. Mental Health Services Administration (SAMHSA); 2020.
Thoma ME, Copen CE, Kirmeyer SE. Short interpregnancy intervals in 2014: differences by maternal demographic characteristics. NCHS Data Brief. 2016;240:1-8.