Opioid abuse during pregnancy is on the rise, new research suggests—and that’s likely to harm both expectant mothers and their children.

Researchers at Oregon Health & Science University (OHSU) analyzed hospital data from California pregnancies. They found that the annual prevalence of opioid use disorder in pregnant women more than doubled between 2008 and 2020. In addition, reported opioid use is associated with worse maternal and newborn health outcomes, including a higher risk of infant death.

“In this large, diverse, population-based cohort study, a prenatal opioid-related diagnosis was associated with a significant risk of maternal and neonatal morbidity,” the researchers wrote in their paper, PUBLISHED this month in the Journal of Addiction Medicine.

On the way up

While opioids are an important part of pain management, they can have dangerous side effects. People can develop an unhealthy dependence on these drugs (formally known as opioid use disorder), and acute opioid overdoses can quickly become fatal.

There are many studies documented how the drug and opioid crisis has worsened in the US over the past decades. But the OHSU authors say there is little research looking at how rates of opioid use change for pregnant women.

Their work analyzed data on hospital discharges from affiliated health care systems in California. This allowed them to look at more than 5 million pregnancies documented in the state between 2008 and 2020.

While the overall percentage of pregnant women with opioid use disorder diagnoses remained low throughout the study period, it increased significantly over time. In 2008, 0.14% of pregnant women had such a diagnosis; in 2020, it increased to 0.33% of pregnant women—more than doubling over that time period.

Women who report opioid use disorder during pregnancy are more likely to have hypertension or develop severe maternal complications, such as bleeding. Similarly, babies born to these mothers are more likely to be born prematurely, require neonatal intensive care, or die.

What should happen

The findings may only show a correlation between maternal opioid use and worse health outcomes, not a direct cause-and-effect link. That said, some research support the idea that opioid use can be dangerous for both mother and child.

The authors of this paper point out that pregnant women are significantly less likely to have the resources needed to treat opioid misuse.

“Pregnant patients already face many difficulties accessing care, but individuals with opioid use disorders face additional barriers,” said study co-author Kristin Prewitt, a fellow in the OHSU section of addiction medicine and department of maternal-fetal medicine, in a statement from the university. “Here in Oregon, only one in four residential treatment programs offer prenatal care, and some counties don’t have available obstetric or addiction care resources.”

There have been some good developments of late. Annual drug and opioid overdose deaths in the US REFUSES in recent years, for example. But pregnant women dealing with opioid use disorder need dedicated, comprehensive health care to help them and their babies, researchers say.

“Evidence shows that linking patients to care early improves outcomes. If we know early that an individual faces these additional risks, we can ensure that they receive personalized, multidisciplinary care in the prenatal and postnatal periods, and finally when they move to pediatric care with their child,” said Prewitt.