(1006) Equity and perinatal urine drug toxicology testing by hospital location.

Friday, January 31, 2025

4:00 PM – 6:00 PM

Submitting Author(s)

Cresta W. Jones, MD (she/her/hers)

Associate Professor
University of Minnesota Medical School
Minneapolis, Minnesota, United States

Presenting Author(s)

Savannah Maynard, BA (she/her/hers)

Medical Student
University of Minnesota Medical School
Minneapolis, MN, United States

Coauthor(s)

CB

Caroline Brumley, BS

Medical Student
University of Minnesota Medical School
Minneapolis, Minnesota, United States
SC

Samantha Considine, MD

Medical Student
University of Minnesota Medical Center
Minneapolis, Minnesota, United States
EB

Emily Biscaye, MD

Resident Physician - Obstetrics and Gynecology
University of Minnesota Medical School
Minneapolis, Minnesota, United States
KT

Katelyn M. Tessier, BS, MS

Senior Biostatistician
University of Minnesota
Minneapolis, Minnesota, United States

Objective: To evaluate racial inequities in perinatal urine toxicology via urine drug screen (UDS) by hospital location.

Study Design: A retrospective cohort study was conducted examining data from pregnancy episodes for all live births occurring at three hospitals (urban vs. suburban vs. rural) within a single health system between January 1, 2019, and March 31, 2019. We assessed racial differences in urine toxicology testing via a UDS, as well as testing results. Data were compared by hospital location.

Results: Among 1368 patients across all hospital locations, 7.3% (n=99) underwent a UDS before delivery, and 15.2% (n=208) were tested at the time of delivery. There were significant associations between hospital location and testing rates, with the suburban hospital demonstrating the lowest rate compared to the urban and rural hospitals for testing both before delivery admission (1.9% vs 12.8% vs 14.7%, respectively; p < 0.001), and at delivery admission (11.9% vs 19.1% vs 18.4%, respectively; p = 0.001). There were no significant differences in the rates of UDS with substances detected between the hospital sites regardless of the timing of testing (p = 0.305 and p = 0.386). There were significant differences between UDS rates by identified patient race, and Black birthing patients were three times as likely as White birthing patients to undergo toxicology testing before delivery (15.4% vs 5.6%, p < 0.001) and twice as likely at delivery (25.8% vs 12.3%, p < 0.001).

Conclusion: While rates of perinatal substance use across racial groups are similar, Black birthing patients are more likely to undergo urine toxicology evaluation compared to their White birthing counterparts, and this appears to differ by hospital location. Policies and practices of perinatal urine drug testing warrant critical review to limit racial inequities in toxicology testing and to better support patients with perinatal substance use.