Category: Clinical Obstetrics
Poster Session II
The objective of this study was to examine the association between substance use disorders (SUD) on various types of 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. Likewise, PCM was defined as a composite including anxiety, depression, ADHD, bipolar disorder, manic episode, and schizophrenia. Multivariable logistic regression analyses were undertaken to predict the likelihood of PCM as a composite among pregnancy hospitalizations with/without SUD as well as to predict the likelihood of each type of PCM in a subgroup of inpatient hospitalizations with 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. Inpatient pregnancy hospitalizations among women with SUD were more likely to include patients who were white (P < .001), age 20-30 (p < .001), publicly insured (p < .001), and with lower income percentiles (p < .001) than those without SUD. Adjusting for relevant sociodemographic covariates, SUD was identified as an independent predictor of PCM (aOR 3.56; 95% CI 3.51-3.60). In subgroup analyses of all pregnancy hospitalizations with PCM, SUD continued to remain a positive predictor of several key types of PCM – ADHD (aOR 1.27; 95% CI 1.21-1.33), bipolar disorder (aOR 2.07; 95% CI 2.00-2.13), manic episode (aOR 2.85; 95% CI 1.44-5.65) and schizophrenia (aOR 2.15; 95% CI 1.99-2.32).
Conclusion:
SUD in pregnancy increased the likelihood of an association with bipolar disorder, manic episode, and schizophrenia by over 2-fold, while also being significantly associated with ADHD. Screening for mental health conditions is imperative while caring for pregnant women with SUDs.
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