Severe maternal morbidity up in Medicaid-enrolled pregnant women with opioid addiction

The rate of opioid use disorder (OUD) is high in Medicaid-enrolled pregnant women, and they have a high rate of severe maternal morbidity (SMM), according to a study published in JAMA Network Open.

Samantha G. Auty, Ph.D., from the Boston University School of Public Health, and colleagues identified 96,309 pregnant women with OUD enrolled in Medicaid in 47 states with 108,975 deliveries in a cross-sectional study to estimate the rates of SMM.

The researchers found that across states, the mean rate of OUD among pregnant women enrolled in Medicaid was 324.8 per 10,000 live births. In this group, the mean unadjusted rate of SMM, excluding blood transfusions, among those with OUD was 292.1 per 10,000 live births, with substantial variation seen across states from 101.0 to 682.2 per 10,000 live births in South Dakota and California, respectively.

The estimated rate of SMM was not meaningfully altered with adjustment for enrollee characteristics and comorbidities. With decreased durations of Medicaid enrollment, rates of SMM generally increased.

“State Medicaid programs are uniquely positioned to implement strategies that address the burden of SMM among pregnant people with OUD,” the authors write. “Doing so will require early identification of pregnant Medicaid enrollees with OUD and implementation of targeted strategies to increase engagement with perinatal care and SUD treatment.”

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