Perinatal & Pediatric
Pregnancy and Infant Outcomes Following Opioid Overdose During Pregnancy Among Individuals with an Opioid Use Disorder Michelle Ann Caesar* Michelle Ann Caesar Caesar Caesar Caesar Caesar Caesar Herbert Wertheim School of Public Health and Human Longevity Science. University of California San Diego, La Jolla, CA
Objective: The objective of this study was to evaluate the effect of having an opioid overdose on pregnancy and infant outcomes among pregnant individuals with an opioid use disorder.
Methods: This retrospective study consisted of singleton, livebirths among individuals with an opioid use disorder in California between 2007 and 2021. Infant records (birth through one year of life) and maternal records (one year before delivery through one year postpartum) were linked to vital statistics birth records. Adjusted risk ratios and risk differences were calculated to estimate the association between opioid overdose among pregnant individuals with an opioid use disorder and preterm birth, neonatal abstinence syndrome, and admission to the NICU.
Results: Overall, 14,073 birthing individuals in California had an opioid use disorder and 190 (1.35%) had an opioid overdose during pregnancy. In those who had an opioid overdose, 50.79% occurred in 1st trimester, 23.81% in the 2nd, and 25.40% in the 3rd. There was no statistically significant difference in the risk of preterm birth, admission to the neonatal intensive care unit, or neonatal abstinence syndrome among individuals with an opioid use disorder who had an opioid overdose during pregnancy compared to those who did not. Additional analyses examining timing showed an increased risk of preterm birth among individuals who had an opioid exposure during the second trimester of pregnancy compared to individuals who did not have an opioid overdose (aRR=2.29, 95%CI: 1.44, 3.65; aRD=0.26, 95% CI: 0.05, 0.47).
Conclusion: This study did not find an increased risk of preterm birth, neonatal abstinence syndrome, or admission to NICU among individuals with an opioid use disorder who experienced an opioid overdose during pregnancy. These findings may suggest that acute overdose events during pregnancy does not confer additional risk beyond the already elevated risk of these adverse outcomes among individuals with an opioid use disorder.