Table 1.
Ratesa of opioid use by maternal sociodemographic, perinatal, behavioral, and hospital characteristics, among pregnancy-related discharges, NIS, 1998–2009.
| Characteristic | N b | 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.