Alison Gemmill, an assistant professor in the department of family, population and preventive medicine at Stony Brook School of Medicine, published a study with other researchers that reveals an increase in opioid-associated deaths among pregnant women and women who recently gave birth.
“We defined the outcome as pregnancy-associated mortality involving opioids,” Gemmill said. “So that means that its death to pregnant women or women who are one-year postpartum and on their death certificates it also says that there was an opioid that was involved in their death.”
Opioid abuse has become a national epidemic, with the number of opioid-related deaths per year increasing roughly four times from 2002 to 2017. The study’s researchers wanted to see if the crisis is related to the increase in maternal mortality in recent years.
The study showed that the opioid-related mortality rate of pregnant and postpartum women roughly tripled from 2007 to 2016. Additionally, the number of opioid-related deaths among all pregnancy-associated deaths has more than doubled in percentage. An increasing share of these deaths had been due to heroin or synthetic opioids, rather than methadone or non-heroin natural opioids. Synthetic opioids are entirely artificially made whereas natural opioids are derived from opium leaves.
“We think that this is mirroring the broader opioid epidemic,” Gemmill said. “We see that women of childbearing age and young men have higher rates of opioid use, and women of childbearing age get pregnant. So we are seeing a confluence of events.”
The opioid-related mortality rate increased more dramatically for pregnant Caucasian women than for pregnant African-American women, according to the study.
“Again, we believe this reflects trends found in the general population. In another study, we note that the U.S. white population saw a sharp rise in opioid-related deaths from the mid-1990s to about 2010 while opioid-related deaths in the black population remained fairly stable over this time,” Dr. Mathew Kiang, an author of the study and postdoctoral research fellow at the Stanford University School of Medicine’s Center for Population Health Sciences, wrote in an email.
Currently, there are steps being taken to address this problem.
“There is a lot of attention being paid now to making sure we are not giving excessive number of opioid prescriptions to patients and that we are managing things on alternative ways, looking at other methods of managing pain,” Dr. David Garry, the director of the maternal-fetal medicine at Stony Brook Medicine, said.
The U.S. Department of Health and Human Services is combating this crisis through a 5-point strategy. Their focuses, according to a speech given by former health and human services secretary Thomas Price, include “improving access to treatment and recovery services, promoting use of overdose-reversing drugs, strengthening our understanding of the epidemic through better public health surveillance, providing support for cutting edge research on pain and addiction, and advancing better practices for pain management.”
“Another thing we would like to note is that we want to bring attention to this matter because pregnant women generally interact with the health care system more often than the general population,” Kiang wrote in an email. “This presents us with multiple opportunities to support the health, safety, and recovery of women with opioid use disorder both during pregnancy and after childbirth.”
