Preconception health service provision among women with and without substance use disorders

Abstract Background Drug and alcohol use during pregnancy is associated with significant adverse birth outcomes and maternal morbidity. Addressing health and risky behaviors before pregnancy, in the preconception period, can improve both maternal and infant outcomes. However, the prevalence of preconception service delivery among women with substance use disorders (SUD) is unknown. Methods Using Optum®, a de-identified Electronic Health Record dataset containing data from 5 million nationally distributed US adults from 2010-2018, we conducted a cross-sectional analysis of 18–55-year-old women with delivery between 2012-2018 (n=52,565). Preconception services received in the year before pregnancy were identified using ICD-9/10 V and Z codes. Logistic regression was used to assess the relationship of any SUD vs. no SUD and preconception services received before and after adjusting for confounding. Results Average age was 29.3 (±5.0 years); 6.4% (n=3,371) of the sample had a diagnosis of any SUD and 6.0% (n=3,144) received any preconception services in the year before pregnancy. Women with SUD vs. without had higher prevalence of receiving any preconception services (9.6% versus 5.7%, p Conclusions There are numerous missed opportunities to provide preconception services to women with and without SUD. While delivering preconception services, healthcare providers have an opportunity to screen for SUD which may be more prevalent among women with psychiatric and medical problems.