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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 4

(1077) Impact of Prenatal Care on Perinatal Outcomes in Individuals with Opioid Use

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: Prenatal opioid use is associated with maternal and neonatal morbidity and mortality, yet only half of individuals are connected to treatment due to barriers accessing care. The objective of this study is to assess how the number of prenatal care attendance affects perinatal outcomes in individuals with opioid use.

Study Design: We conducted a retrospective cohort of singleton, non-anomalous births between 23-42 weeks gestation using California linked vital statistics and hospital discharge data (2008-2020). Opioid-related diagnosis was identified using ICD-9/ICD-10 codes. Prenatal visit number grouping (≥5 visits and < 5 visits) was determined based on WHO recommendations for minimum visits to mitigate adverse perinatal outcomes. Chi-squared and multivariable logistic regression were utilized for statistical analyses.

Results: There were 8,799 individuals with opioid use in pregnancy that met inclusion criteria, with the majority attending ≥5 prenatal care visits (80.34%). Attendance at < 5 prenatal care visits was associated with adverse maternal outcomes, including a higher rate of placental abruption (6.2% vs 2.7%; aOR 1.87, 95% CI: 1.42-2.47), preterm premature rupture of membranes (8.0% vs 3.8%; aOR 1.91, 95% CI: 1.50-2.43), preterm delivery < 37 weeks (33.0% vs 14.2%; aOR 2.69, 95% CI: 2.34-3.08), and severe maternal morbidity (6.5% vs 2.8%; aOR 2.31, 95% CI: 1.77-3.02). Neonatal outcomes were also worse in those with fewer prenatal visits, including higher rates of respiratory distress (4.6% vs 2.6%; aOR 1.78, 95% CI: 1.31-2.42), neonatal withdrawal (37.6% vs. 29.4%, aOR 1.42, 95% CI: 1.26-1.61), and NICU admission (58.4% vs 41.9%; aOR 1.76, 95% CI: 1.57-1.99).

Conclusion: We found that lower prenatal care attendance among individuals with an opioid-related diagnosis is associated with worse maternal and neonatal outcomes. Although our study is limited by the ability to control for pharmacotherapy, addressing barriers to prenatal care among those with opioid use may impact maternal and neonatal morbidity and mortality.