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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Health Equity/Community Health

Poster Session 2

(555) Geographic differences in co-occurring perinatal mood and anxiety disorders and substance use during pregnancy

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  
Objective:
Substance use disorders (SUD) and perinatal mood and anxiety disorders (PMAD) are common and independently associated with adverse pregnancy outcomes, yet their co-occurrence is not well understood. This study assesses differences by rural and urban residence in rates of co-occurring SUD and PMAD during pregnancy.

Study Design:
We conducted a cross-sectional study using linked Medicaid claims and birth certificate records from Oregon and South Carolina from 2016 to 2020. We identified SUD and PMAD diagnoses during pregnancy and within 60 days postpartum using International Classification of Disease-10 codes. We compared those with SUD by diagnosis of any PMAD using chi-square tests. We used Rural-Urban Community Area codes to identify rural versus urban residence.

Results:
Out of 185,809 births, 18,670 (10.0%) were identified as having SUD and 43,759 with PMAD (23.6%). Substance use disorders (SUDs) were significantly more common among individuals with PMAD compared to those without, across both rural and urban settings (p < 0.001 for all). Tobacco use was most prevalent, affecting 41.2% of rural and 38.9% of urban individuals with PMAD. Rates of cannabis, opioid, alcohol, sedative, and stimulant use were 2–6 times higher among those with PMAD. Among individuals with PMAD, substance use was generally higher in rural compared to urban settings, with rural cases showing up to 22% higher stimulant use and 14% higher alcohol use.

Conclusion:
PMADs are associated with SUD during pregnancy, especially in rural areas. Targeted screening and intervention are needed to address this dual burden and improve maternal and neonatal morbidity and mortality.