MedicalResearch.com Interview with:
Lindsay Admon, MD MSc
Assistant Professor, Department of Obstetrics & Gynecology
Institute for Healthcare Policy and Innovation
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
In our previous work (https://journals.lww.com/greenjournal/Fulltext/2017/12000/Disparities_in_Chronic_Conditions_Among_Women.19.aspx), we identified higher rates of deliveries complicated by substance use among rural women. We knew that some of this difference would be accounted for by opioids.What we didn’t expect was that when we took a closer look, amphetamine use disorder accounted for a significant portion of this disparity as well.
The main findings of this study are that, between 2008-09 and 2014-15, amphetamine and opioid use among delivering women increased disproportionately across rural compared to urban counties in three of four census regions. By 2014-15, amphetamine use disorder was identified among approximately 1% of all deliveries in the rural western United States, which was higher than the incidence of opioid use in most regions.
Compared to opioid-related deliveries, amphetamine-related deliveries were associated with higher incidence of the majority of adverse gestational outcomes that we examined including pre-eclampsia, preterm delivery, and severe maternal morbidity and mortality.
MedicalResearch.com: What should readers take away from your report?
Response: Use of both substances represent worsening public health crises. These data underscore the need for the maternal health community to direct attention not only towards opioids, but towards the use of other substance as well, particularly amphetamines.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: There is some data that stopping amphetamine use in pregnancy is associated with improved outcomes at birth—but as clinicians, we need clear guidance on how to best promote cessation among pregnant patients with amphetamine use disorders. We also need comprehensive data to guide patients to treatment services, particularly in rural regions where both obstetric and addiction treatment resources may be harder to access.
I have no disclosures. One author on the study is an expert witness for Bayer.
Amphetamine- and Opioid-Affected Births: Incidence, Outcomes, and Costs, United States, 2004–2015
Lindsay K. Admon MD, MSc, Gavin Bart MD, PhD, Katy B. Kozhimannil PhD, MPA, Caroline R. Richardson MD, Vanessa K. Dalton MD, MPH, and Tyler N. A. Winkelman MD, MSc
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