Presentation (CTI)

OBJECTIVES: Evidence on factors associated with overdose among perinatal women with opioid use disorder (OUD) remains limited. Identifying risk factors can inform life-saving interventions. The objectives of this research were to identify commonly reported opioids of dependence and evaluate factors associated with overdose risk among perinatal women with OUD.
METHODS: We conducted a cross-sectional survey of women with OUD (n=198) who were pregnant, had miscarried in the past 24 months, or were within 12 months post-partum in a large healthcare system. The survey captured self-reported overdose in the past year (“yes” vs. “no”), and sociodemographic characteristics (ethnicity[Hispanic/non-Hispanic], race[White/others], age, annual household income ["$25,000 or less"/"above $25,000"], housing status [“stable housed”/"temporary housed or homeless”], and addiction severity, measured by summing binary responses to DSM-V diagnostic criteria for OUD. Commonly reported opioids of dependence were assessed using a multiple-response item. Descriptive statistics summarized participant characteristics and commonly misused opioids. Multivariable logistic regression assessed the association between overdose history and a combination of addiction severity and participants' sociodemographic variables.
RESULTS: The most commonly reported opioids of dependence were prescription pain relievers such as oxycodone (75.4%). Others were heroin (59.6%), and fentanyl (52%) and carfentanil (15.2%). Among 198 participants, 28 reported experiencing an overdose in the previous year. Logistic regression results indicated that addiction severity and ethnicity were significant predictors of overdose. Hispanic women were four times more likely to experience overdose (OR=4.3, 95%CI=1.32-14.04, p=0.016). Each additional unit increase in addiction severity was associated with a higher likelihood of overdose (OR=1.32, 95%CI=1.09-1.60, p=0.004).
CONCLUSIONS: Our findings highlight prevalent contemporary opioids of dependence and key factors influencing overdose among perinatal women with OUD. Interventions that reduce addiction severity and address disparities among Hispanic women may help mitigate overdose risks among this patient population. Future studies should identify cost-effective options for preventing overdose among this population.