(1078) Opioid Prescriptions during Pregnancy by Race and Ethnicity in Utah’s urban and rural counties, 2014-2017

To examine 2014-2017 prevalence and trends in receipt of opioid prescriptions during pregnancy by race and ethnicity in Utah’s urban and rural counties.


Study Design:

Retrospective cohort study using Utah All Payer Claims Data (2014-2017) to evaluate receiving >1 opioid prescriptions during any trimester of pregnancy prior to delivery. We included all individuals with pregnancies >20 weeks’ gestation. We categorized race and ethnicity as Hispanic and non-Hispanic: Black, American Indian/Alaska Native (AI/AN), Asian/Pacific Islander (API), and White. County of residence was classified as urban (>100 people per sq. mile) or rural ( < 100 people per sq. mile). We calculated age-adjusted prevalence and prevalence ratios of receiving opioid prescriptions during pregnancy by race and ethnicity stratified by urban and rural counties. Logistic regression models were used to evaluate linear trends in prevalence over time.


Results:

From 2014-2017,192,451 individuals with pregnancies were identified. Of these, 21,881 (11.4%) received >1 opioid prescriptions during pregnancy. In urban counties, the age-adjusted prevalence of receiving >1 opioid prescriptions decreased in all race and ethnicity groups from 2014-2017: Black (2.5%; p=.21), Hispanic (5.0%; p< .001), AI/AN (15.0%; p< .001), API (2.7%; p=.002), and White (4.0%; p< .001) (Figure). In rural counties, the prevalence also decreased over time in all groups: Black (3.6%; p=.60), Hispanic (5.4%; p< .001), AI/AN (5.6%; p=.04), API (8.8%; p< .05), and White (4.7%; p< .001). Compared to White individuals, age-adjusted prevalence was higher among those who were Black, Hispanic, and AI/AN and lower among those who were API in urban and rural counties (Table).


Conclusion:

From 2014-2017, the proportion of pregnant individuals receiving opioid prescriptions decreased among all race and ethnicity groups in urban and rural counties in Utah. However, race and ethnicity disparities in receipt of opioid prescriptions persisted, with higher prevalence among pregnant individuals who were Black, Hispanic, and AI/AN versus White.