Prenatal Intravenous Drug Use at Treatment Admission in the United States: Evidence From the Treatment Episode Data Set–Admissions (TEDS-A)

Prenatal intravenous (IV) drug use poses serious maternal and neonatal risks, yet national evidence among pregnant women entering substance use treatment remains limited. We analyzed 2012–2022 TEDS-A data for 80,253 pregnant women. IV drug use was defined as injection reported as the usual route of substance administration. Multivariable logistic regression estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Overall, 30.6% reported IV drug use. Higher odds were observed among women aged 25–29 years (aOR = 2.49), with prior treatment (aOR = 2.21), experiencing homelessness (aOR = 1.46), using substances daily (aOR = 1.48), and with ≥2 recent arrests (aOR = 1.77). Lower odds were observed among married women (aOR = 0.81), college graduates (aOR = 0.68), Black women (aOR = 0.14), and Hispanic women (aOR = 0.48). IV drug use was common at treatment entry, underscoring the need for integrated, pregnancy-centered interventions and longitudinal research on maternal and neonatal outcomes.