Given the increasing prevalence of opioid dependence among pregnant women, we sought to compare obstetric and neonatal outcomes between women using illicit substances and/or substitution therapy and those using prescription opioids.METHODS:
We reviewed all pregnancies with ICD-9 codes reflecting chronic opioid use (greater than 30 days during pregnancy) between 2000 and 2015 at a single large academic medical center. We compared pregnancies affected by illicit opioids and/or opioid substitution therapy with those affected by prescription opioid use.RESULTS:
Fifty-four pregnancies were affected by illicit substance use and/or opioid substitution therapy and 22 were affected by prescription opioid use. Mothers had similar rates of obstetric co-morbidity. Mothers in the illicit/substitution therapy group were more likely to have a NICU consult during the antenatal period (P=.01). Infants in the illicit/substitution therapy group were more likely to be diagnosed with neonatal abstinence syndrome (P=.01). Infants in both groups had longer hospital stays than their mothers (21.96±19.18 for infants vs 2.82±1.00 for mothers, P<.0001 in the illicit/substitution group and 13.05±13.70 for infants vs 2.54±1.14 for mothers, P=.005 in the prescription group).CONCLUSION:
Women using prescription opioids in pregnancy do not have different obstetric co-morbidities when compared to women using illicit substances and/or substitution therapy. Mothers with pregnancies complicated by any type of opioid exposure have infants with hospital stays significantly longer than would be predicted and would benefit from antenatal NICU consultation regardless of the type of opioid used.