Category: Clinical Obstetrics
Poster Session IV
This study was undertaken to evaluate the impact of substance use disorders (SUD) on psychiatric comorbidities (PCM) among inpatient pregnancy hospitalizations.
Study Design:
We conducted a cross-sectional analysis of inpatient pregnancy hospitalizations from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) from 2016 to 2019. ICD-10 codes were used to identify patients with a SUD and/or PCM. SUD was defined as a composite - alcohol, tobacco, cannabis, cocaine, sedative, opioid, hallucinogen and stimulant use disorders. Our primary outcome was rate of PCM as a composite of anxiety, depression, ADHD, bipolar disorder, manic episode, and schizophrenia. Univariate analyses compared the prevalence of PCMs across women with/without SUDs. Multivariable logistic regression analyses were undertaken to predict the likelihood of PCM among pregnancy hospitalizations with/without SUD as well as to predict the likelihood of PCM for each individual type of SUD in a subgroup of hospitalizations with SUD and PCM.
Results:
Of the 2,967,969 inpatient pregnancy hospitalizations included in the analyses, 184,766 (6.22%) had SUD diagnosis and 208,828 (7.04%) had a PCM diagnosis. The prevalence of PCM was significantly higher among pregnancy hospitalizations with SUD (39,689/184,766 – 21.48%) vs. without SUD (169,139/2,783,203 – 6.07%, p< .001). Pregnancy hospitalizations with SUD were over 3 times more likely to have a PCM compared to those without SUD (aOR 3.56; 95% CI 3.51-3.60), while adjusting for relevant sociodemographics. In subgroup analyses based on SUD type, the likelihood of PCM was strongest for alcohol (aOR 2.17; 95% CI 2.03-2.31) and sedatives (aOR 2.99; 95% CI 2.63-3.40) and significantly higher for cocaine (aOR 1.74; 95% CI 1.64-1.85), cannabis (aOR 1.39; 95% CI 1.35-1.43), stimulants (aOR 1.11; 95% CI 1.06-1.17), opioid use disorder (aOR 1.48; 95% CI 1.44-1.53), and polysubstance use (aOR 1.55; 95% CI 1.52-1.59).
Conclusion:
SUD in pregnancy is a significant predictor of PCMs – for SUDs overall and while considering the impact of individual substance use disorders.
Justine Keller, MD
MFM Fellow
Saint Louis University
St. Louis, Missouri, United States
Noor Al-Hammadi, MBBCH, MPH
Saint Louis University
St. Louis, Missouri, United States
Sabel Bass, MBBCH
Saint Louis University
St. Louis, Missouri, United States
Niraj R. Chavan, MD, MPH
Saint Louis University School of Medicine
St. Louis, Missouri, United States