Researchers report that mothers are admitting to misusing opioids during pregnant, which is harmful to both the mother and developing child.
In a recent survey, the Centers for Disease Control and Prevention (CDC) found that one in five women using prescription opioids during pregnancy reported misuse. An estimated 6.6% of respondents reported prescription opioid use, and among these women, 21.2% reported misuse.
“Of more than 1,400 women who used opioids during pregnancy, 21% self-reported misuse, stating that they received prescriptions from sources other than healthcare providers, or used opioids for non-pain-related reasons,” said Jean Ko, PhD, of the CDC’s Division of Reproductive Health in Atlanta, and colleagues.
“While more than 90% of women reported getting medication from a healthcare provider, only 68% were counseled on how opioid use might affect their pregnancy,” researchers reported in the agency’s Morbidity and Mortality Weekly Report.
“Given about 20% of those reporting opioid use reported misuse, that means a little bit over 1% of the population may be affected by opioid misuse during pregnancy,” said Lindsay Admon, MD, of the University of Michigan in Ann Arbor, not involved in the research. “That’s a really striking number to think about.” She added, “This report is the first to document self-reported prescription opioid use among expectant mothers. The data on misuse have important clinical implications for screening patients, as well as counseling on dosage, frequency, and potential harms of opioid use while pregnant.”
Sarah Osmundson, MD, of Vanderbilt University Medical Center in Nashville, also not involved in the research, said, “I think the thing that always stands out are questions about giving women opioids during pregnancy. The hard part is that there really aren’t a lot of great options for pain management during pregnancy. Especially as we consider the risks of prescribing opioids, it’s really worth considering all of the medications we have available to treat pain.”
The CDC analyzed 2019 survey data from the Pregnancy Risk Assessment Monitoring System (PRAMS), covering 32 states, as well as survey data from two states not in PRAMS. Maternal demographics collected included age, race/ethnicity, education, trimester of entry into prenatal care, and number of previous live births, as well as pregnancy depression and cigarette smoking. There were 21,000 survey respondents in total.
“Women who had depression during pregnancy were more than twice as likely to report opioid use, and those who smoked during the last three months of pregnancy also had higher usage rates,” the CDC found. “Around 55% reported getting their medication from an OBGYN, midwife, or prenatal care provider, and 25 % received their opioids from an emergency medicine doctor.” Thirty-six percent of those who misused opioids during pregnancy said they wanted to cut back.
The study concluded that “Obstetric providers should discuss risks and benefits of opioid therapy for chronic pain during pregnancy, [and] screen all pregnant women for substance use, misuse, and use disorders, including those involving prescription opioids, and provide referral and treatment, as indicated.” Opioid use while pregnant can be harmful to both the mother and child.