Poster Session 2
Category: Epidemiology
Poster Session 2
India Perez-Urbano, MD
Resident Physician
Columbia University - NY Presbyterian
Columbia University - NY Presbyterian, New York, United States
Maria Andrikopoulou, MD
Assistant Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center
New York, New York, United States
Mary E. D'Alton, MD
Obstetrician and Gynecologist-in-Chief
Willard C. Rappleye Professor and Chair
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center
New York, New York, United States
Alexander M. Friedman, MD, MPH
Professor of Obstetrics and Gynecology
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center
New York, New York, United States
Timothy Wen, MD, MPH
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Peripartum opioid-related mortality has been on the rise. Social determinants of health (SDOH) have been associated with poorer clinical outcomes. To objective of this study was to evaluate risk factors for opioid use-related 6-month postpartum readmissions, and to explore associated trends and clinical outcomes.
Study Design:
Delivery hospitalizations and 180-day postpartum readmissions with de novo opioid use disorder (OUD) diagnoses were identified from the 2016-2021 Nationwide Readmissions Database. Delivery hospitalizations with pre-existing OUD were excluded. Primary exposures of interest were SDOH relating to education/employment, physical environment, and social factors identified using ICD-10 codes. Temporal trends in OUD-related readmissions were assessed utilizing joinpoint regression to determine average annual percent change (AAPC) with 95% confidence intervals (CI). Unadjusted and adjusted logistic regression models were fit to assess the association between SDOH and 180-day de novo OUD readmissions, adjusting for demographic and clinical factors.
Results:
Of 10,285,974 delivery hospitalizations, there were 3,659 postpartum readmissions with de novo OUD (3.5 per 10,000). The prevalence of 180-day OUD-related postpartum readmission decreased from 4.5 to 2.4 per 10,000 delivery hospitalizations in 2016 to 2022 (AAPC: -10.4%, 95% CI -13.5%, -7.8%). Presence of education/employment (18.2 vs. 3.6 per 10,000), physical environment (73.5 vs. 3.5 per 10,000), and social SDOH (14.8 vs. 3.5 per 10,000) were associated with higher prevalence of OUD-related readmissions. Adjusted analysis demonstrates physical environment factors were the only SDOH factor associated with OUD-related readmission (aOR 4.49, 95% CI: 3.04, 6.62).
Conclusion:
While OUD-related postpartum readmissions are decreasing, findings suggest that individuals with physical environment SDOH factors remain at disparately higher likelihood. Early identification of socioeconomic vulnerability and linkage to supportive resources has the potential to mitigate risk of opioid-related adverse outcomes in the postpartum period.