Increase in overdose mortality greater among the pregnant in 2020

Overdose mortality among pregnant and postpartum women increased between 2017 and 2020, with a more pronounced increase observed in 2020, according to a research letter published in the Dec. 6 issue of 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 files for 2017 to 2020 to examine changes in overall and drug-specific overdose mortality among pregnant and .

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 observed in the pregnancy-associated overdose mortality from 6.56 to 11.85 per 100,000 during the study period (relative increase of 81 percent). Among reproductive-aged persons identified on 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 during any previous years. Large increases in deaths involving and other synthetics and psychostimulants were seen from 2017 to 2020, while pregnancy-associated overdose deaths involving benzodiazepines, heroin, and prescription opioids were mostly stable. In 2020, increases in deaths due to fentanyl and other synthetics were especially 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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