New report details increase in opioid-related maternal hospital stays in Pennsylvania

Clearfield County had one of the highest rates of opioid-related maternal hospital stays from the two-year period 2016-2017, according to a new research brief from the PA Health Care Cost Containment Council (PHC4).

During 2016-2017, Clearfield County hospitals had 80 pregnancy-related stays that involved opioid use, for an overall rate of 54 opioid-related hospital stays per 1,000 maternal hospital stays. Only Elk County had a higher rate, with 75.8 hospital stays involving maternal opioid use per 1,000 maternal hospital stays.

In contrast, Centre County logged 23 maternal hospital stays where opioid use was detected, for an overall rate of 10 opioid-related hospital stays per 1,000 maternal hospital stays, one of the lower rates in the state.

But the problem is not just limited to central Pennsylvania. Across the state, PHC4 found that substance use was present in 1 out of every 25 maternal hospital stays during 2016-2017. Within that sample, almost half of the 11,103 maternal hospital stays where substance abuse was reported involved an opioid drug.

Between 2000 and 2017, the rate of maternal hospital stays that involved opioid use went from 3.0 per 1,000 hospital stays to 19.6 per 1,000 hospital stays.

According to the research brief, several factors affected rates of opioid use in expectant mothers: poverty, educational attainment and race.

In areas where more than 40 percent of the population lives in poverty, the opioid use rate was 26.4 per 1,000 maternal hospital stays. But in lower poverty areas, where less than 10 percent of the population lives in poverty, the rate was 14.4 per 1,000 stays.

Similarly, in areas with lower levels of education attainment, where less than 10 percent of the population has a bachelor’s degree, the opioid use rate was 25.8 per 1,000 maternal hospital stays. In areas with high levels of educational attainment, where 40 percent or more of the population has a bachelor’s degree, the opioid use rate was 9.7 per 1,000 maternal hospital stays.

Non-Hispanic white mothers and expectant mothers had the highest rate of opioid use at 24.5. Black non-Hispanic mothers and expectant mothers had a rate of 11.6 and Hispanic mothers and expectant mothers had a rate of 6.0.

The costs of opioid use during pregnancy are high. According to the research brief, nearly 48 percent of deliveries that involved maternal opioid use in 2016-2017 were premature (babies with less than 37 weeks of gestation) or early term (babies with 37-38 weeks of gestation), compared with 33 percent of deliveries that did not involve opioid use.

Nearly 82 percent of maternal stays involving opioid use had Medicaid as the primary anticipated payer in 2016-2017, compared to about 39 percent of maternal stays without opioid use.