ECHO Study Examines Characteristics Associated with Opioid Use During Pregnancy

Collaborative ECHO research led by Ruby Nguyen, PhD of the University of Minnesota and Monica McGrath, ScD of Johns Hopkins University Bloomberg School of Public Health, described characteristics that were associated with opioid using during pregnancy. The study included over 20,000 pregnant people from across the United States and found that the majority of individuals who used opioids during pregnancy were non-Hispanic White and college educated. The researchers also found that opioid use was more common among people who used tobacco or illegal drugs and those who had a history of depression or anxiety. This research, titled “Characteristics of Individuals in the U.S. who Used Opioids during Pregnancy,” is published in the Journal of Women’s Health.

Opioids are a class of drugs commonly used as prescription pain relievers that can cause dependence or addiction. Opioid use has disproportionally impacted pregnant people and their fetuses and previous studies of opioid use during pregnancy have been limited in size and scope. The stigmatization of this population has also affected the collection of data on maternal opioid use during pregnancy. This study utilized a large, geographically diverse group of pregnant people from 32 ECHO cohorts across the U.S. to investigate rare exposures and factors that may affect an individual’s risk for opioid use during pregnancy.

During this study, the researchers analyzed data from pregnant people who were enrolled in ECHO cohorts between 1991 and 2021. They used medical records, laboratory tests, and self-reported information to assess opioid use and potentially related factors. Of the 21,905 pregnancies evaluated, only 591 (2.8%) involved opioid use. The majority of opioid use during pregnancy originated from a prescription.

“This was among the largest observational studies of opioid use in pregnancy, and the diverse sample of pregnant people better represents the U.S. population than previous studies,” said Dr. Nguyen. “These findings will help to inform further research on screening tools for opioid use during pregnancy, and the finding that most opioid use originates from prescriptions reinforces the need to better monitor the amount of circulating prescription drugs, particularly in pregnant people.”

Further research is needed to understand the factors that contribute to the use of multiple substances during pregnancy and the interrelationship between substance use and depression or anxiety. The results of this study can contribute to the development of screening tools and procedures for identifying individuals who are potentially at-risk for opioid use during pregnancy.

Read the research summary.