Relationship between opioid use disorder during pregnancy, delivery-related outcomes, and healthcare utilization in Michigan Medicaid, 2012-2021
Recommended Citation
Shuman CJ, Zhang X, Hall SV, Tilea A, Clark SJ, Vance AJ, Courant A, and Zivin K. Relationship between opioid use disorder during pregnancy, delivery-related outcomes, and healthcare utilization in Michigan Medicaid, 2012-2021. J Subst Use Addict Treat 2025; 175:209720.
Document Type
Article
Publication Date
8-1-2025
Publication Title
J Subst Use Addict Treat
Abstract
INTRODUCTION: Pregnant individuals with opioid use disorder (OUD) deliver >20,000 infants annually in the United States, with serious health consequences for perinatal individuals and their infants. This study compares delivery-related outcomes and healthcare utilization among Michigan Medicaid-enrolled perinatal individuals with and without an OUD diagnosis.
METHODS: We conducted a retrospective cohort study among Michigan Medicaid enrollees aged 15-44 who delivered a live infant between 2012 and 2021.
RESULTS: The cohort included 218,890 deliveries among 170,002 individuals enrolled continuously in Michigan Medicaid for nine months before delivery and up to three months postpartum. Of those, 3.26 % had an OUD diagnosis during this analytic period. Perinatal individuals with OUD identified primarily as White (82.9 %), lived in urban areas (77.2 %), and had a lower income (68.6 %). Among individuals with OUD, 31 % had another behavioral health diagnosis and 55.1 % received a prescription for a psychotropic medication. Of those with OUD, 47.4 % received a prescription for medication for OUD. Deliveries with OUD versus without OUD had a lower probability of cesarean delivery (aOR = 0.89) but higher odds of preterm delivery (aOR = 1.31). Those with OUD had higher likelihood of ambulatory (aOR = 1.99), ED/observational (aOR = 1.19), psychotherapy (aOR = 5.48), and substance use disorder care (aOR = 27.05) visits than those without OUD.
CONCLUSIONS: Medicaid-enrolled perinatal individuals in Michigan with OUD had higher rates of preterm birth and healthcare utilization compared to those without OUD. Clinicians and policymakers should target early detection and tailored, coordinated treatment to better address the needs of these individuals.
Medical Subject Headings
Humans; Female; Pregnancy; Medicaid; Michigan; United States; Adult; Retrospective Studies; Opioid-Related Disorders; Young Adult; Adolescent; Pregnancy Complications; Patient Acceptance of Health Care; Pregnancy Outcome; Infant, Newborn; Premature Birth; Cesarean Section
PubMed ID
40328372
Volume
175
First Page
209720
Last Page
209720
