Category: Clinical Obstetrics
Poster Session II
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 a SMM event. SUD was defined as a composite including alcohol, tobacco, cannabis, cocaine, sedative, opioid, hallucinogen and stimulant use disorder. Our primary outcome was rate of SMM analyzed as a composite, as defined by the CDC. Univariate analyses compared the prevalence of SMM across women with and without SUD. Multivariable logistic regression analyses were performed to predict the likelihood of SMM among pregnancy hospitalizations with and without SUD as well as to predict the likelihood of SMM for each individual type of SUD in a subgroup of hospitalizations with SUD and SMM.
Results:
Of the 2,967,969 inpatient pregnancy hospitalizations included in the analyses, 184,766 (6.22%) had SUD diagnosis and 61,294 (2.07%) had a SMM diagnosis. The prevalence of SMM was significantly higher among pregnancy hospitalizations with SUD (5,809 / 184,766 – 3.14%) vs. without SUD (55,485 / 2,783,203 – 1.99%, p< .001). Pregnancy hospitalizations with SUD were 1.5 times more likely to have a SMM event as compared to those without SUD (aOR 1.51; 95% CI 1.46-1.55), while adjusting for relevant sociodemographic characteristics. In subgroup analyses based on type of SUD - the likelihood of SMM was strongest for sedatives (aOR 2.52; 95% CI 1.98-3.21) and stimulants (aOR 2.64; 95% CI 2.44-2.87) and remained significantly higher for alcohol (aOR 1.56; 95% CI 1.35-1.79), cocaine (aOR 1.57; 95% CI 1.39-1.77), opioids (aOR 1.48; 95% CI 1.37-1.59), as well as polysubstance use (aOR 1.27; 95% CI 1.21-1.35).
Conclusion:
SUD in pregnancy is a significant predictor of SMM – for SUDs overall as well as while considering the impact of each individual type of SUD.
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