745 - Impact of COVID-19 Pandemic on Substance Use during Pregnancy

Publication Number: 745.5339

Olivia Venvertloh, Creighton University School of Medicine, Phoenix, AZ, United States; Megan A. Witsoe, Creighton University School of Medicine, Scottsdale, AZ, United States; Sara C. Esteves, Creighton University School of Medicine, Scottsdale, AZ, United States; Laura M. Cogua, Creighton University School of Medicine, Phoenix, AZ, United States; Jenna K. Moses, Creighton University School of Medicine, Phoenix, AZ, United States; Vanuyen Pham, Creighton University School of Medicine, Phoenix, AZ, United States; Paul Kang, Creighton University School of Medicine Phoenix, Phoenix, AZ, United States; Pooja Doehrman, Creighton University School of Medicine, Phoenix, AZ, United States; Hemananda Muniraman, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States

Background: The COVID-19 pandemic has led to increased psychological stress and contributed to worse mental health outcomes. Isolation and decreased ability to cope with stressors have been reported to be associated with higher rates of illicit substance use particularly in vulnerable populations during pregnancy and childbirth. Recent studies have reported changes in the trend of type and increased rates of illicit substance use during pregnancy.

Objective: To evaluate the effect of the COVID-19 pandemic on the type and rates of maternal substance abuse.

Design/Methods: A single-center retrospective study including pregnant women admitted with a positive history and urine screen for illicit substance use during pregnancy over a four-year study period between February 2018 and March 2022. Baseline characteristics, type, and rates of substance use in pregnancy and treatment programs were compared across two epochs: Pre-pandemic; February 2018-2020, and the Pandemic period: March 2020-2022.

Results: A total of 1179 pregnant women with a positive history and urine screen results for illicit substance use during pregnancy were included in the study with 464 women (39.2%) in the pre-pandemic period and 717 (60.8%) in the pandemic period. The pandemic study period population was noted to have a higher proportion of non-Hispanic white women( 50% vs 37%), higher Medicaid insurance coverage (9.8% vs 1.5%), and lower gravida (3.5% vs 4.2%) (Table 1). There were higher rates of fentanyl (26% vs 1.3%), lower methadone (8.7% vs 12.6%), and lower methamphetamine (30% vs 36.3%) during the pandemic time study period. There were decreased proportions of pregnant mothers who were being treated in a community-based substance use treatment program during the pandemic study period (Table 2).

Conclusion(s): There was a significant increase in maternal fentanyl use during the COVID-19 pandemic period. In our study, the pandemic was associated with deceased pregnant women treated in community treatment programs, which may be related to limited access during the pandemic. The pandemic period may have also impacted the socio-demographics of pregnant women using illicit drugs.

Table 1: Sociodemographics and Access to Prenatal Care by COVID Time Periods
2-sample T-test to compare continuous variables. Chi-squared Analysis or Fisher’s Exact Test to compare categorical variables.

Table 2: Comparison of Substance Use During Pregnancy
Chi-squared Analysis or Fisher’s Exact Test to compare categorical variables.