- The Washington Times - Thursday, August 9, 2018

The share of pregnant women who gave birth while hooked on opioids more than quadrupled as the U.S. addiction crisis exploded, the government said Thursday in the first multistate analysis of the epidemic’s potential impact on newborns and their moms.

The Centers for Disease Control and Prevention said the rate of deliveries from women with opioids use disorder spiked from 1.5 per 1,000 in 1999 to 6.5 in 2014.

Vermont had the highest opioid-affected birth rate overall in 2014 — nearly 49 per 1,000 deliveries — followed by West Virginia, at 32 per 1,000.

Opioid addiction during pregnancy is linked to a range of problems for mothers and their babies, including maternal death, stillbirth and neonatal abstinence syndrome (NAS), in which newborns enter the world suffering from withdrawal symptoms.

Signs or symptoms of NAS will vary from child to child, though most appear within three days of birth and can last from one week to six months, according to the March of Dimes, a nonprofit that focuses on the health of moms and babies.

Symptoms include tremors and seizures, excessive crying, breathing problems, fever and trouble sleeping, among others.

“Untreated opioid use disorder during pregnancy can lead to heartbreaking results,” CDC Director Robert Redfield said. “Each case represents a mother, a child, and a family in need of continued treatment and support.”

The share of pregnant women misusing opioids is a growing concern for policymakers, who see babies born with withdrawal as some of the most sympathetic figures in the fight against rampant addiction.

First lady Melania Trump, who took an interest in the issue after President Trump declared opioid misuse a public health emergency, recently visited the Vanderbilt Children’s Hospital in Tennessee to meet with affected families.

During a panel discussion, Dr. Stephen Patrick of Vanderbilt University said the hospital has seen “a massive increase in pregnant women with opioid use disorder, and that’s disproportionately occurring in rural areas.”

He pointed to a lack of insurance coverage and financial problems as barriers to treatment.

In Washington, Capitol Hill lawmakers have steered more grant funding toward NAS, while the administration in June urged states to leverage Medicaid dollars for treatment.

CDC researchers found increases in NAS in all 28 states it examined. Annual increases were lowest in California and Hawaii and greatest in Maine, New Mexico, Vermont and West Virginia, which also suffers from the highest opioid-overdose death rate in the nation.

“Even in states with the smallest annual increases, more and more women are presenting with opioid use disorder at labor and delivery,” said Wanda Barfield, director of the CDC’s Division of Reproductive Health. “These state-level data can provide a solid foundation for developing and tailoring prevention and treatment efforts.”

The CDC issued a number of recommendations to stem the problem.

Some of them apply to the opioids fight at large, since high rates of misuse among pregnant women parallel excessive rates of opioid prescribing in specific states.

The agency said doctors should adhere to the CDC’s opioid prescribing guidelines and use of prescription-drug monitoring programs, so they know whether expectant mothers are trying to get pills from other prescribers, too.

Other recommendations were tailored toward pregnant women, specifically.

The CDC says women should be screened for substance abuse at their first prenatal visits and given access to medication-assisted therapy or other addiction services.

Moms should also get adequate support after giving birth, including mental health and drug treatment, and family planning services, the agency said.


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