Overdose Deaths in Pregnant, Postpartum Women Increased From 2018 to 2021

The number of overdose deaths in women aged 35 to 44 years who were pregnant or postpartum tripled from 2018 to 2021 in the United States, according to a cross-sectional study.

Researchers sought to examine the sociodemographic characteristics and socioeconomic factors among pregnancy-associated overdose deaths. The researchers also compared pregnancy-associated overdose deaths with obstetric decedents and overdose decedents who were not pregnant in the past year.

The study included 1457 pregnant and postpartum overdose decedents, 4796 obstetric decedents, and 11,205 overdose decedents who were not pregnant. The ages of the individuals included in the study ranged from 10 to 44 years.

The study’s researchers defined pregnancy-associated deaths as “deaths during pregnancy or within 1 year of pregnancy termination. Additionally, the study focused on drug overdoses that were either unintentional or with an undetermined intent involving the most common psychotropic drugs of misuse.

Overall, the researchers found that pregnancy-associated overdose mortality ratios consistently increased from 2018 to 2021. Further, mortality ratios more than tripled among pregnant and postpartum women aged 35 to 44 years—4.9 in 2018 to 15.8 in 2021.

Compared with women who died from obstetric causes, pregnant women and girls who died from overdose were more likely to be non-college graduates (72.1% vs 59.4%), unmarried (88.0% vs 62.1%); and more likely to have died in a “nonhome, non-health care setting” (25.9% vs 4.5%).

This study had limitations. For example, the researchers noted that the US mortality data did not include several important factors, specifically the decedents’ health insurance status, family income, and employment status. Because of this, the researchers did not examine those factors. “Most pregnancy-associated overdose deaths occurred outside health care settings, indicating the need for strengthening community outreach and maternal medical support,” the researchers concluded. “To reduce pregnancy-associated overdose mortality, evidence-based interventions are urgently needed at individual, health care, local, and national levels, along with nonpunitive approaches incentivizing pregnant and postpartum women to seek substance use disorder treatments,” the researchers concluded.

Reference:
Han B, Compton WM, Einstein EB, Elder E, Volkow ND. Pregnancy and postpartum drug overdose deaths in the US before and during the COVID-19 pandemic. JAMA Psychiatry. Published online November 22, 2023. doi:10.1001/jamapsychiatry.2023.4523