Black and Hispanic Women Were Less Likely Than White Women to Receive Medications for Opioid Use Disorder During Pregnancy

Methadone and buprenorphine (i.e., medications for opioid use disorder [MOUD]) are recommended for treating opioid use disorder (OUD) during pregnancy. Investigators used data from a statewide Massachusetts quality improvement initiative to examine whether maternal race/ethnicity were associated with receiving MOUD during pregnancy and several other infant outcomes. Among 1710 deliveries to women with OUD in 24 hospitals, maternal and infant outcomes for non-Hispanic White women were compared with non-Hispanic Black and Hispanic women using multivariable mixed-effects regression models.

  • During pregnancy, 68% of the cohort received MOUD and had no non-prescribed opioid use, 20% received MOUD and had non-prescribed opioid use, and 13% had non-prescribed opioid use and received no MOUD.
  • Compared with non-Hispanic White women, non-Hispanic Black and Hispanic women were less likely to receive MOUD (adjusted odds ratio [aOR], 0.34 and 0.43, respectively).
  • A greater percentage of non-Hispanic White women received buprenorphine than non-Hispanic Black or Hispanic women.
  • Infant outcomes—including pharmacologic treatment of neonatal opioid withdrawal syndrome, in-hospital care, and whether they were discharged home with a biological parent—were not significantly associated with race/ethnicity.

Comments: Most women with OUD in this cohort received MOUD during pregnancy, but non-Hispanic Black and Hispanic women were less likely than non-Hispanic White women to receive treatment. Consistent with other studies, receipt of buprenorphine was greatest among the non-Hispanic White group. Medicaid and MOUD availability in Massachusetts likely positively influenced receipt of MOUD in this study, but reasons for differences based on race/ethnicity deserve additional exploration.

Aaron D. Fox, MD

Reference: Peeler M, Gupta M, Melvin P, et al. Racial and ethnic disparities in maternal and infant outcomes among opioid-exposed mother-infant dyads in Massachusetts (2017-2019). Am J Public Health. 2020;110(12):1828–1836.

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