# The effects of state policies on opioid use disorders in pregnant women: prevalence, treatment and outcomes

> **NIH AHRQ R01** · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · 2021 · $396,441

## Abstract

Abstract
 The current opioid crisis has resulted in increases in opioid use and abuse during pregnancy that
parallel national trends of substance use. Between 2000 and 2012, the incidence of maternal opioid use during
pregnancy increased from 1.19 to 5.77 per 1000 hospital live births per year. Maternal opioid use during
pregnancy is associated with increased risks of prolonged hospital stay, maternal death, placental abruption,
poor fetal growth, preterm labor, premature delivery, and stillbirth. Maternal opioid use can also result in
neonatal abstinence syndrome (NAS), an opioid withdrawal condition occurring in 55-94% of infants whose
mothers used opioids in pregnancy, the incidence of which has increased over the past decade. Opioid
prescribing practices, rates of opioid use in pregnancy, and incidence of NAS vary substantially between
states, suggesting that state policies may affect maternal, fetal, and neonatal outcomes. Indeed, state responses
regarding treatment of opioid use disorders in pregnancy have varied widely and included creation of funded
drug-treatment programs specifically for pregnant women, priority access to state-funded treatment
programs, mandated reporting and drug screening by healthcare professionals, and criminalization of the
behavior with grounds for commitment. While a public health response to the opioid epidemic has been
proposed in favor of punitive action, evidenced-based data about what specific public health strategies result
in the best outcomes for opioid-using mothers and their infants are limited. We propose to use two large,
national databases to better understand the effects of these state policies on the prevalence of OUD in pregnant
women, as well as patterns of prenatal and OUD care utilization, pregnancy complications and adverse
outcomes, and costs. By using data from the MarketScan® Commercial Claims and Encounters and the
Medicaid Analytic eXtract (MAX) files, this study will provide a comprehensive assessment of the effects of
these policies on maternal and neonatal outcomes in pregnant women with OUD. This proposal, responsive to
AHRQ’s Special Emphasis Notice (NOT-HS-18-015) calling for research to evaluate “state, local, and health
system policy efforts to address the opioids crisis,” will address the following aims: 1) Examine the effects of
state policies governing the treatment of pregnant women with OUD on the prevalence of OUD in pregnant
women; 2) Examine the effects of state policies on patterns of treatment and costs, both for prenatal care and
OUD treatment, for pregnant women with OUD; and 3) Examine the effects of state policies on maternal and
child outcomes and costs for pregnant women with OUD. This study will take advantage of a unique set of
databases that will allow for a comprehensive examination of the effects of state policies on treatment patterns
and maternal and neonatal outcomes for pregnant women with OUD. The information generated from the
study will be crucial to p...

## Key facts

- **NIH application ID:** 10178085
- **Project number:** 5R01HS026917-03
- **Recipient organization:** PENNSYLVANIA STATE UNIV HERSHEY MED CTR
- **Principal Investigator:** DOUGLAS L. LESLIE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $396,441
- **Award type:** 5
- **Project period:** 2019-09-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10178085

## Citation

> US National Institutes of Health, RePORTER application 10178085, The effects of state policies on opioid use disorders in pregnant women: prevalence, treatment and outcomes (5R01HS026917-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10178085. Licensed CC0.

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