Describing Preterm Birth in Patients With Opioid Use in Delaware [ID 1348]

INTRODUCTION: The opioid epidemic continues to worsen, and in 2022, Delaware had the fourth highest rate of overdose-related deaths in the United States. In pregnancy, opioid use disorder (OUD) is associated with increased risks of fetal growth restriction, abruption, and preterm birth (PTB). This study describes PTBs in patients with OUD. METHODS: This was a retrospective study obtained via chart review, deidentified, and included all patients with a positive urine drug screen (UDS) for opioids who delivered in one Delaware hospital between January 2018 and December 2021. RESULTS: Six hundred seventy-seven (2.3%) of all patients had a positive UDS for opiates. Compared to the Delaware average of 10.8%, 21.3% of patients experienced PTB. Late PTBs and early PTBs comprised 17.1% and 4.5% of all births, respectively. Patients with positive UDS were 1.6 times more likely to experience early PTB and 2.4 times more likely to experience late PTB. Of all PTBs, 37.5% were medically indicated, and 33.3% and 29.2% resulted from spontaneous preterm labor and preterm prelabor rupture of membranes, respectively. Of all patients, 8% had a medically indicated PTB and 13.3% had a spontaneous PTB. CONCLUSIONS/IMPLICATIONS: Patients with OUD are more than twice as likely to experience PTB than those without OUD. The majority of these PTBs are in the late preterm period, and deliveries follow national distributions in rate of spontaneous versus medically indicated deliveries. Delaware needs additional resources devoted towards caring for patients with OUD to mitigate disparities in PTB.