Table 1.
Characteristics of pregnancies with opioid use disorder in Pennsylvania Medicaid, overall and stratified by opioid pharmacotherapy, 2009–2015*
| Characteristic | Overall n=12,587 |
No pharmacotherapy n=5,553 |
Methadone n=3,618 |
Buprenorphine n=3,416 |
p-value⸶ |
|---|---|---|---|---|---|
| Demographics | |||||
| Age [years; mean ±SD] | 27.7 ± 4.7 | 27.3 ± 4.8 | 28.0 ± 4.5 | 27.8 ± 4.6 | <0.01 |
| 15–19 | 331 (2.6) | 218 (3.9) | 59 (1.6) | 54 (1.6) | <0.01 |
| 20–34 | 11357 (90.2) | 4970 (89.5) | 3281 (90.7) | 3106 (90.9) | |
| ≥ 35 | 899 (7.1) | 365 (6.6) | 278 (7.7) | 256 (7.5) | |
| Race and ethnicity | |||||
| Non-Hispanic white | 11047 (87.8) | 4511 (81.2) | 3277 (90.6) | 3259 (95.4) | <0.01 |
| Non-Hispanic black | 961 (7.6) | 703 (12.7) | 174 (4.8) | 84 (2.5) | |
| Hispanic | 393 (3.1) | 253 (4.6) | 105 (2.9) | 35 (1.0) | |
| Other | 186 (1.5) | 86 (1.6) | 62 (1.7) | 38 (1.1) | |
| County of residence | |||||
| Urban | 10229 (81.3) | 4492 (80.9) | 3201 (88.5) | 2536 (74.2) | <0.01 |
| Rural | 2358 (18.7) | 1061 (19.1) | 417 (11.5) | 880 (25.8) | |
| Medical co-morbidities | |||||
| Psychiatric disorderǂ | 5370 (42.7) | 2288 (41.2) | 1617 (44.7) | 1465 (42.9) | <0.01 |
| Hepatitis C virus (HCV) | 3879 (30.8) | 1324 (23.8) | 1539 (42.5) | 1016 (29.7) | <0.01 |
| Asthma | 1812 (14.4) | 810 (14.6) | 528 (14.6) | 474 (13.9) | 0.60 |
| Chronic hypertension | 450 (3.6) | 209 (3.8) | 125 (3.5) | 116 (3.4) | 0.59 |
| Thyroid disorder | 390 (3.1) | 166 (3) | 107 (3.0) | 117 (3.4) | 0.43 |
| Diabetes mellitus | 188 (1.5) | 89 (1.6) | 62 (1.7) | 37 (1.1) | 0.06 |
| HIV | 78 (0.6) | 32 (0.6) | 31 (0.9) | 15 (0.4) | 0.07 |
| Pregnancy-associated co-morbidities | |||||
| Hypertensive disorder | 1335 (10.6) | 661 (11.9) | 370 (10.2) | 304 (8.9) | <0.01 |
| Gestational diabetes | 917 (7.3) | 447 (8.1) | 234 (6.5) | 236 (6.9) | 0.01 |
| Substance use in pregnancy | |||||
| Alcohol | 856 (6.8) | 467 (8.4) | 198 (5.5) | 191 (5.6) | <0.01 |
| Tobacco | 9009 (71.6) | 3747 (67.5) | 2767 (76.5) | 2495 (73.0) | <0.01 |
| Polysubstance use§ | 10338 (82.1) | 4132 (74.4) | 3377 (93.3) | 2829 (82.8) | <0.01 |
| Medication-assisted treatment (MAT) utilization | |||||
| Behavioral health counseling (≥ 1 visit) | 4930 (39.2) | 2007 (36.31) | 1466 (40.5) | 1457 (42.7) | <0.01 |
| Counseling classification | |||||
| Drug and alcohol | 2946 (59.8) | 1241 (61.8) | 817 (55.7) | 888 (60.9) | <0.01 |
| Psychiatric disorder | 391 (7.9) | 108 (5.4) | 124 (8.5) | 159 (10.9) | |
| Both | 649 (13.2) | 243 (12.1) | 204 (13.9) | 202 (13.9) | |
| Other | 944 (19.1) | 415 (20.7) | 321 (21.9) | 208 (14.3) | |
| Opioid pharmacotherapy | |||||
| None | 5553 (44.1) | 5553 (100) | |||
| Methadone | 3618 (28.8) | 3618 (100) | |||
| Buprenorphine | 3416 (27.1) | 3416 (100) | |||
*
n (%) unless otherwise specified;
⸶
difference comparing 2009 to 2015;
ǂ
defined as a diagnosis of major depressive disorder, bipolar disorder, or schizophrenia;
§
defined as a diagnosis of cocaine, marijuana, amphetamine, hallucinogen and/or sedatives use during pregnancy