Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States
Table 1
Ratesa of opioid use by maternal sociodemographic, perinatal, behavioral, and hospital characteristics, among pregnancy-related discharges, NIS, 1998–2009.
Characteristic
Ratea of opioid use (95% CI)
ORc (95% CI)
AORd (95% CI)
Overall
55,781,965
2.48 (2.18–2.78)
n/a
n/a
Maternal age (years)
13–19
6,198,796
0.93 (0.82–1.04)
0.35 (0.31–0.38)
0.23 (0.21–0.26)
20–24
13,822,023
2.47 (2.16–2.77)
0.91 (0.85–0.98)
0.62 (0.58–0.66)
25–29
15,001,057
2.70 (2.35–3.05)
Reference
Reference
30–34
12,797,406
2.76 (2.37–3.15)
1.02 (0.94–1.11)
1.36 (1.26–1.47)
≥35
7,921,464
2.84 (2.41–3.28)
1.05 (0.97–1.15)
1.37 (1.25–1.50)
Other/unknown
41,218
0.37 (<0.00–0.89)
0.14 (0.03–0.56)
0.15 (0.03–0.66)
Maternal race
White, non-Hispanic
22,047,327
2.90 (2.52–3.28)
Reference
Reference
Black, non-Hispanic
6,025,913
3.24 (2.32–4.17)
1.12 (0.88–1.43)
0.61 (0.48–0.78)
Hispanic
9,444,177
1.33 (1.07–1.59)
0.46 (0.37–0.56)
0.31 (0.25–0.38)
Other, non-Hispanic
4,079,383
1.02 (0.80–1.24)
0.35 (0.28–0.44)
0.26 (0.21–0.34)
Missing/unknown
14,185,165
2.68 (2.02–3.35)
0.93 (0.70–1.22)
0.98 (0.78–1.23)
Tobacco use
Yes
2,009,092
21.60 (18.71–24.50)
12.50 (11.41–13.70)
6.67 (6.07–7.33)
No
53,772,873
1.76 (1.56–1.97)
Reference
Reference
Alcohol use
Yes
96,629
81.02 (71.00–91.04)
37.56 (33.98–41.52)
7.17 (6.42–7.99)
No
55,685,336
2.34 (2.06–2.62)
Reference
Reference
Hospital region
Northeast
9,516,239
4.47 (3.66–5.28)
2.60 (1.88–3.60)
2.16 (1.60–2.92)
Midwest
12,032,900
2.35 (1.74–2.96)
1.37 (0.94–1.98)
0.88 (0.60–1.28)
South
20,796,015
2.13 (1.61–2.65)
1.24 (0.86–1.78)
0.87 (0.63–1.18)
West
13,436,811
1.72 (1.26–2.19)
Reference
Reference
Hospital location
Rural
6,877,937
1.36 (1.15–1.58)
Reference
Reference
Urban
48,763,827
2.64 (2.30–2.98)
1.94 (1.58–2.38)
2.22 (1.80–2.74)
Hospital teaching status
Nonteaching
29,501,465
1.63 (1.43–1.82)
Reference
Reference
Teaching
26,140,299
3.44 (2.85–4.04)
2.12 (1.72–2.62)
1.68 (1.33–2.12)
Hospital bed size
Small
6,100,955
2.39 (1.84–2.94)
0.89 (0.63–1.28)
0.82 (0.59–1.13)
Medium
14,821,822
2.67 (1.94–3.39)
Reference
Reference
Large
34,718,987
2.42 (2.06–2.77)
0.91 (0.66–1.23)
0.95 (0.72–1.26)
Household income
Lowest quartile
14,617,169
3.58 (3.06–4.10)
2.53 (2.19–2.93)
1.54 (1.36–1.82)
2nd quartile
14,070,584
2.50 (2.18–2.82)
1.76 (1.58–1.97)
1.20 (1.09–1.33)
3rd quartile
13,294,169
2.18 (1.89–2.47)
1.54 (1.41–1.67)
1.17 (1.08–1.26)
Highest quartile
12,830,659
1.42 (1.23–1.60)
Reference
Reference
Missing/unknown
969,383
3.63 (3.02–4.24)
2.56 (2.17–3.03)
1.43 (1.17–1.75)
Primary payer
Medicare/medicaid
22,249,834
4.51 (3.89–5.14)
6.90 (6.07–7.84)
8.87 (7.66–10.27)
Private
29,701,613
0.66 (0.59–0.73)
Reference
Reference
Other
3,830,518
4.79 (4.18–5.41)
7.33 (6.54–8.22)
9.20 (8.16–10.38)
AOR = adjusted odds ratio, CI = confidence interval, NIS = Nationwide Inpatient Sample, OR = odds ratio.
aPer 1,000 pregnancy-related discharges.
bWeighted to estimate national frequency and may not add to total due to missing data.
cCrude model comparing the odds of maternal opioid use across different levels of each characteristic, separately.
dA single multivariable model includes all characteristics that appear in the table.
