Title : Patterns of maternal and infant healthcare utilization following prenatal substance use
Abstract:
Background: Prenatal substance exposure to opioids, tobacco, and marijuana has been linked to adverse health outcomes in children. However, the relationship with early childhood medical service utilization remains underexplored, particularly in distinguishing between specific substances. Gaining insights into these relationships can guide patient education and optimize healthcare delivery and availability for affected populations.
Objective: To explore patterns of medical service among mothers and infants following prenatal substance exposure to tobacco, marijuana, or opioids.
Methods: A retrospective cohort analysis was conducted using data from the Maternal- Child EMR project, including 242 mother-infant pairs (185 with prenatal substance exposure; 57 controls). Maternal outcomes included prenatal visits, maternal-fetal medicine (MFM) consultations, specialist referrals, emergency department (ED) visits, hospitalizations, and outpatient surgeries. Infant outcomes included non-well child pediatrician visits, ED visits, and hospitalizations during the first year of life. Statistical models controlled for significant confounding background variables.
Results: Mothers with substance use had higher rates of prenatal care adequacy, MFM consults, and ED visits. Opioid use was uniquely associated with increased outpatient surgeries but fewer inpatient hospitalizations. Infants exposed to opioids showed significantly higher rates of non-well child pediatric visits, ED visits, and hospitalizations. In contrast, those exposed to tobacco or marijuana had significantly fewer non-well child visits and ED visits.
Conclusions: Prenatal substance use influences healthcare utilization patterns for both mothers and infants, with opioid exposure linked to greater infant medical needs. Conversely, reduced utilization among tobacco- and marijuana-exposed infants may reflect barriers to care or lack of parental awareness. Future research should investigate underlying factors affecting care-seeking behavior and develop targeted interventions to improve access and outcomes for these vulnerable groups.
