Disparities Persist in SUD Treatment Needs Among Pregnant Women

Substantial disparities persist in substance use disorder (SUD) treatment among pregnant women in the US, according to study results published in Addictive Behaviors.

Substance use during pregnancy poses significant risks to both maternal and neonatal health, yet access to and engagement with treatment services remain suboptimal.

To explore the potential of SUD-related risk prevention, researchers examined whether sociodemographic disparities observed in SUD treatment and receipt persisted during pregnancy.

A retrospective, population-based analysis was conducted among pregnant women in the US, using data from the Survey of Drug Use and Health. Logistic regression models were used to assess factors associated with SUD treatment needs among pregnant women and receipt of SUD treatment for those with requiring care.

Obstetric practitioners should receive additional education to provide SUD treatment referrals to women in high-risk groups to improve access to care.

The study included 3461 adult participants (52.1% had mean age, 26-34 years, 59.9% married; 55.9% non-Hispanic White; 93.2% heterosexual women).

Researchers noted the following results among study participants:

• Despite the need for SUD treatment, only 20% of women requiring treatment reported receiving any SUD treatment in the previous year.
• The majority of pregnant women (92.2%) reported not having SUD or receiving treatment for SUD.
• In adjusted analyses examining predictors of SUD treatment needs, unmarried vs married women with a pregnancy had more than 3-fold higher odds of requiring treatment (odds ratio [OR], 3.33; 95% CI, 2.20-5.03; P <.001).
• Bisexual vs heterosexual women also demonstrated increased odds of requiring treatment (OR, 2.36; 95% CI, 1.35-4.13; P =.01).
• Women with pregnancy and a comorbid mental illness had more than 5-fold higher odds of requiring SUD treatment (OR, 5.58; 95% CI, 3.98-7.82; P =.001).
• Non-Hispanic Black vs White pregnant women had significantly lower odds of requiring SUD treatment (OR, 0.47; 95% CI, 0.28-0.80; P =.001).
• Hispanic or Latina women with lower income were less likely than White women with higher income to have SUD (OR, 0.39; 95% CI, 0.17-0.87; P =.02).
• The odds of SUD treatment needs decreased modestly over time.
• Unmarried women were more likely than those who were married to receive SUD treatment (OR, 8.23; 95% CI, 2.28-29.70; P =.002).
• Older age was associated with greater treatment receipt, with women aged 26 to 34 years and those aged 35 years and older showing higher odds of receiving care, compared with women aged 18 to 25 years (ORs, 4.72 vs 4.15 vs 4.11, respectively; P =.049, P =.01, and P =.023, respectively).
• Two factors contributed to disparities in SUD treatment among pregnant women: a concern in supply of having high-quality treatment options and a concern in demand of identifying effective specialty treatments.

The study was limited by reliance on self-reported survey data; only 20% of participants meeting criteria for a mental illness in the past year; and only 7.8% of pregnant women met criteria for SUD treatment need.

“Obstetric practitioners should receive additional education to provide SUD treatment referrals to women in high-risk groups to improve access to care,” the study authors concluded.

This article originally appeared on Psychiatry Advisor