Pregnant Mortality: Increase in Overdose Greater Among the Pregnant in 2020

Overdose mortality increased by about 81 percent from 2017 to 2020 among pregnant and postpartum women

Overdose mortality among pregnant and postpartum women increased between 2017 and 2020. There is a more pronounced increase observed in 2020, according to a research letter published in the Journal of the American Medical Association.

Emilie Bruzelius, M.P.H., and Silvia S. Martins, M.D., Ph.D., from the Columbia University Mailman School of Public Health in New York City, used data from the restricted National Vital Statistics System mortality files for 2017 to 2020 to examine changes in overall and drug-specific overdose mortality among pregnant and postpartum women.

The researchers found that 1,249 of the 7,642 pregnancy-associated deaths between 2017 and 2020 were overdose-related, corresponding to a cumulative overdose mortality rate of 8.35 per 100,000. There was an increase in pregnancy-associated overdose mortality from 6.56 to 11.85 per 100,000 during the study period (a relative increase of 81 percent).

Among reproductive-aged persons identified on death certificates as female, overdose mortality increased similarly from 14.37 to 19.76 per 100,000 (relative increase, 38 percent). The increases in overdose mortality for both groups were more pronounced in 2020 than in previous years.

Significant increases in deaths involving fentanyl and other synthetics and psychostimulants were seen from 2017 to 2020, while pregnancy-associated overdose deaths involving benzodiazepines, heroin, and prescription opioids were primarily stable. In 2020, increases in deaths due to fentanyl and other synthetics were specially marked.

“The findings indicate that enhanced strategies supporting substance use prevention, treatment, and harm reduction efforts among pregnant and postpartum persons are needed,” the authors write.

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