TABLE 1—
Racial/Ethnic Differences in Opioid-Exposed Mother–Infant Dyad Characteristics: Massachusetts Perinatal-Neonatal Quality Improvement Network Database, 2017–2019
| All Participants (n = 1710), No. (%) or Median (IQR) | Non-Hispanic White, (n = 1527), No. (%) or Median (IQR) | Non-Hispanic Black (n = 57), No. (%) or Median (IQR) | Hispanic (n = 126), No. (%) or Median (IQR) | P | |
| Maternal exposures | |||||
| Maternal opioid exposurea | < .001 | ||||
| Untreated OUD | 213 (12.5) | 170 (11.1) | 14 (24.6) | 29 (23.0) | |
| Stable treated OUD | 1154 (67.5) | 1055 (69.1) | 29 (50.9) | 70 (55.6) | |
| Unstable treated OUD | 343 (20.1) | 302 (19.8) | 14 (24.6) | 27 (21.4) | |
| Any maternal nonprescribed opioid use | 556 (32.5) | 472 (30.9) | 28 (49.1) | 56 (44.4) | < .001 |
| Any MOUD during pregnancy | 1497 (87.5) | 1357 (88.9) | 43 (75.4) | 97 (77.0) | < .001 |
| Type of MOUD prescribed | < .001 | ||||
| Methadone only | 699 (40.9) | 616 (40.3) | 21 (36.8) | 62 (49.2) | |
| Buprenorphine only | 784 (45.9) | 727 (47.6) | 22 (38.6) | 35 (27.8) | |
| Methadone and buprenorphineb | 14 (0.8) | 14 (0.9) | 0 (0) | 0 (0) | |
| No MOUD | 213 (12.5) | 170 (11.1) | 14 (24.6) | 29 (23.0) | |
| Other maternal exposures | |||||
| Alcohol | 53 (3.1) | 48 (3.1) | 0 (0) | 5 (4.0) | .34 |
| Benzodiazepine | 252 (14.7) | 228 (14.9) | 6 (10.5) | 18 (14.3) | .65 |
| Cocaine | 326 (19.1) | 275 (18.0) | 18 (31.6) | 33 (26.2) | .004 |
| Marijuana | 462 (27.0) | 397 (26.0) | 21 (36.8) | 44 (34.9) | .023 |
| Nicotine | 884 (51.7) | 779 (51.0) | 37 (64.9) | 68 (54.0) | .1 |
| Amphetamines | 134 (7.8) | 120 (7.9) | 5 (8.8) | 9 (7.1) | .93 |
| SSRI | 165 (9.6) | 150 (9.8) | 8 (14.0) | 7 (5.6) | .16 |
| Geography of delivery hospitalization | |||||
| Region | < .001 | ||||
| West | 430 (25.2) | 383 (25.1) | 13 (22.8) | 34 (27.0) | |
| Central | 311 (18.2) | 269 (17.6) | 8 (14.0) | 34 (27).0 | |
| Northeast | 301 (17.6) | 282 (18.5) | 1 (1.8) | 18 (14.3) | |
| Metro Boston | 333 (19.5) | 296 (19.4) | 22 (38.6) | 15 (11.9) | |
| Southeast | 335 (19.6) | 297 (19.5) | 13 (22.8) | 25 (19.8) | |
| Infant characteristics | |||||
| Gestation age, wk | 39 (37–39) | 39 (37–39) | 39 (38–39) | 38 (36–39) | .044 |
| Male sex | 874 (51.1) | 775 (50.8) | 33 (57.9) | 66 (52.4) | .55 |
| Term (≥ 37 wk) | 1404 (82.1) | 1262 (82.7) | 50 (87.7) | 92 (73.0) | .013 |
| Inborn at hospital | 1624 (95.0) | 1451 (95.0) | 54 (94.7) | 119 (94.4) | .99 |
| NOWS severity and engagement outcomes | |||||
| Length of stay, d | 12 (6–20) | 12 (6–20) | 14 (8–22) | 13 (7–20) | .28 |
| Received pharmacological therapy | 845 (49.6) | 748 (49.2) | 33 (57.9) | 64 (51.2) | .41 |
| Received skin to skin | 1219 (71.6) | 1092 (71.8) | 42 (73.7) | 85 (67.5) | .54 |
| Roomed in for ≥ 1 night | 1424 (76.2) | 1170 (76.9) | 42 (73.7) | 87 (69.1) | .13 |
| Any maternal breastmilk during hospitalization | 856 (76.8) | 773 (76.1) | 24 (80.0) | 59 (85.5) | .18 |
| Social services outcomes | |||||
| Early intervention referral | 1338 (78.7) | 1192 (78.6) | 45 (78.9) | 101 (80.2) | .92 |
| Discharge to biological parent | 1259 (74.1) | 1136 (74.8) | 37 (64.9) | 86 (68.8) | .09 |
Note. IQR = interquartile range; MOUD = medications used to treat opioid use disorder; NOWS = neonatal opioid withdrawal syndrome; OUD = opioid use disorder; SSRI = selective serotonin reuptake inhibitor.
Untreated OUD = nonprescribed opioid use including heroin, fentanyl, and nonmedical use of prescription opioids (including methadone or buprenorphine) during the pregnancy without any MOUD received; stable treated OUD = prescribed MOUD with no nonprescribed opioid use during pregnancy; and unstable treated OUD = concomitant prescribed MOUD use with nonprescribed opioid use during pregnancy.
Evidence of receipt of both prescribed methadone and buprenorphine at some point during pregnancy, not at the same time.