Disparities in Receipt of Medications for Opioid use Disorder among Pregnant Women

作者：Laura E. Henkhaus, Melinda Beeuwkes Buntin, Sarah Clark Henderson, Pikki Lai, Stephen W. Patrick · 发表于：Substance Abuse · 年份：2021 · DOI：10.1080/08897077.2021.1949664 · 被引用次数：42 · 研究领域：Prenatal Substance Exposure Effects、Maternal Mental Health During Pregnancy and Postpartum、Gestational Diabetes Research and Management

Background: Medications for opioid use disorder (MOUD) improve outcomes for pregnant women and infants. Our primary aim was to examine disparities in maternal MOUD receipt by family sociodemographic characteristics. Methods: This retrospective cohort study included mother-infant dyads with Medicaid-covered deliveries in Tennessee from 2009 to 2016. First, we examined family sociodemographic characteristics – including race/ethnicity, rurality, mother's primary language and education level, and whether paternity was recorded in birth records – and newborn outcomes by type of maternal opioid use. Second, among pregnant women with OUD, we used logistic regression to measure disparities in receipt of MOUD by family sociodemographic characteristics including interactions between characteristics. Results: Our cohort from Medicaid-covered deliveries consisted of 314,965 mother-infant dyads, and 4.2 percent were exposed to opioids through maternal use. Among dyads with maternal OUD, MOUD receipt was associated with lower rates of preterm and very preterm birth. Logistic regression adjusted for family sociodemographic characteristics showed that pregnant women with OUD in rural versus urban areas (aOR: 0.66; 95% CI: 0.60–0.72) and who were aged ≥35 years versus ≤25 years (aOR: 0.75; 95% CI: 0.64–0.89) were less likely to have received MOUD. Families in which the mother's primary language was English (aOR: 2.47; 95% CI: 1.24–4.91) and paternity was recorded on the birth certificate (aO...