Opioid abuse in pregnant women increases 127% in 14 years

The number of pregnant women who abuse or are dependent on opioids (narcotics) jumped 127 percent in 14 years, leading to an increased risk of maternal death and stillbirth among other serious problems, according to a review of more than 57 million American women admitted for delivery. The results were published in the December issue of Anesthesiology, the official medical journal of the American Society of Anesthesiologists® (ASA®).

Opioid abuse or dependence in pregnant women more than doubled between 1998 and 2011, and was even greater among 20- to 34-year olds, growing by 162 percent in that time period. In addition to maternal deaths and stillbirths, the use of opioids was also associated with poor growth of the fetus, longer length of stay in the hospital, premature labor and cesarean delivery.

"Opioid abuse and dependence has grown dramatically in the general U.S. population, and our findings show that this epidemic extends to pregnant women," said Lisa R. Leffert, M.D., lead author of the study and chief of obstetric anesthesia at Massachusetts General Hospital, Boston. "More research is needed to understand the factors leading to opioid abuse and dependence in these women and the ways in which we can help to mitigate the complications associated with these issues during pregnancy and childbirth."

About one in seven women is prescribed opioids during pregnancy, according to a previous study by the same authors. For this study, the researchers analyzed data from the Nationwide Inpatient Sample (NIS), including nearly 57 million pregnant women admitted to U.S. hospitals for delivery between 1998 and 2011. At the beginning of the study, 1.7 of every 1,000 women abused or were dependent on opioids at the time of labor, and 14 years later, that number increased to 3.9 per 1,000 delivery admissions. The increase was greatest in women 20- to 34-years old: the number of women of that age dependent on or abusing opioids grew from 1.8 to 4.5 out of every 1,000 deliveries.

Reviewing data from the last five years of the NIS, the researchers found that women who abused or were dependent on opioids were nearly five-fold more likely to die during hospitalization, and were more likely to deliver by cesarean and have extended hospital stays than those who did not abuse or were not dependent on narcotics. Further, their babies were about twice as likely to be stillborn, preterm (born early), and have intrauterine growth restriction (poor growth). In addition, placental abruption (when the placenta separates from the wall of the uterus prematurely) was almost three times more common in these patients. These associations largely remained when opioid abusing or dependent women were compared to non-opioid drug abusing or dependent women.

"Our study shows that these patients are at very high risk for developing complications. Given the rapid rise in opioid abuse and dependence in these patients, there is an urgent need to understand the link with bad outcomes and to develop interventions to help prevent them," said Dr. Leffert


  1. david becker david becker United States says:

    Opioids- an American Tragedy of greed, carelessness, and lack of regulation. Shame on the medical profession who continues to care less about infants rights when it comes to pain care. Shame on the medical profession and Universities for failing to have education in pain care- and shame on politicians who allow this injustice to continue.

  2. david becker david becker United States says:

    This is another reason why doctors need to have education in pain care and use less opioids and make use of other treatments for pain. Opoids are too dangerous and not effective enough to be used for pregnant woemn. Unfortunately, medicine has a long history of negating and dismissing the rights of infants when it comes to pain care. It is time for medicine to be much more compassionate towards all people in pain-and if and when medicine becomes more compassionate toward people in pain-then there will be less use of opioids for all pain conditions- including pain during pregnancy.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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