A Systematic Study on the Prevalence of Alcohol and Marijuana use in Pregnant Women with Opioid Use Disorder View PDF

Madgula Niharika Sarma
Medicine, Dr Patnam Mahendar Reddy Institute Of Medical Science, India

Published on: 2024-10-01

Abstract

Approximately 25% of pregnant women drink alcohol, 7.4 out of 1000 deliveries are affected by opioid use disorder (OUD), and cannabis use is on the rise among pregnant women. Despite this, there is little information about marijuana co-exposure in women who use multiple substances. Using the well-characterized ENRICH-1 cohort, which studied the effects of two primary exposures of interest-opioids and alcohol-the authors estimated the prevalence of marijuana use in those with OUD and or alcohol use and also examined correlates of marijuana use in those with OUD and or alcohol use. There were 194 participants with OUD, 100 with alcohol, and 94 with both OUD and alcohol. Based on self-reports and biomarkers, substance abuse was determined. The correlation between marijuana uses and multivariate logistic regression was identified. According to the OUD, OUD + alcohol, and alcohol groups, 46%, 52%, and 49% of pregnant women used marijuana. 20%, 22%, and 26% of participants reported weekly or daily use. Compared to women who took methadone (38%), those who took buprenorphine (46% and 60%, respectively) were significantly more likely to use marijuana. Marijuana users were generally younger than non-marijuana users in all three groups. There was a significant association between maternal age, and polysubstance use independent of group, race/ethnicity, education, and smoking. It was found that there was a significant interaction between partnership status and group: women in the OUD and OUD + alcohol groups had lower odds of marijuana use than those in the alcohol group. Women in the alcohol group who were partners had lower odds of using marijuana than women who were unpartnered. The authors conclude that women who are treated for OUD during pregnancy and or who consume alcohol during pregnancy are more likely to use marijuana. As a result of these findings, ongoing risk reduction strategies are needed for pregnant women receiving OUD treatment as well as pregnant women exposed to alcohol.

Keywords

Opioids, Pregnancy, Alcohol, Marijuana, Women

Introduction

People across the lifespan have been affected by the opioid epidemic in USA, including pregnant women and newborns. Pregnant women enrolled in Medicaid in 2023 used prescription opioids during pregnancy at a rate of 31.2% [1, 2]. According to recent studies, more than 8% of pregnant women used opioids for non-medical reasons during pregnancy. 7.4 /1000 deliveries are affected by OUD in pregnant women, an increase of 400% between 2010 and 2023 [3]. It is estimated that OUD is more prevalent in some states than in others, such as West Virginia and Vermont, and in New Mexico the rate is 18.3/1000. Prenatal opioid exposure has been linked to intrauterine growth restriction, preterm delivery, and stillbirth in numerous studies [4]. In terms of long-term neurodevelopmental outcomes, it is unclear whether prenatal opioid exposure, medications for OUD (MOUD), neonatal opioid withdrawal syndrome (NOWS), and/or treatment for NOWS are related to poor outcomes or whether adverse pre- and postnatal environmental factors are primarily responsible [5]. The risk of unplanned healthcare utilization among infants with NOWS during their first year of life has been demonstrated by a recent study [6]. It is important to take into account the effects of polydrug use, such as co-exposure with marijuana, alcohol, stimulants, or other substances, when assessing obstetric and neonatal outcomes [7, 8]. Alcohol and tobacco are among the most common co-exposures that adversely affect the offspring’s neurodevelopment. The prevalence of binge drinking, and tobacco use in pregnant women with OUD has been shown to be almost 31% and 90%, respectively. In addition, emerging evidence indicates prenatal marijuana exposure may be associated with adverse perinatal outcomes, including preterm birth, growth restriction, and increased neonatal intensive care unit admissions [9-11]. There was no significant association between marijuana use in the third trimester and adverse perinatal outcomes found in a retrospective cohort study of 191 mothers and infants exposed to buprenorphine during pregnancy, but marijuana co-exposure was associated with more severe NOWS [12, 13].