Characterizing sociodemographic differences in substance use treatment need and receipt among pregnant women in the U.S.

OBJECTIVE

Sociodemographic disparities in SUD treatment need and receipt among women inform public health initiatives. While rates of SUD among pregnant women are lower than those who are not pregnant, an investigation of whether and how sociodemographic disparities of SUD treatment need and receipt among pregnant women can further accelerate SUD related risk prevention for both mothers and babies.

METHOD: We analyzed data from pregnant women who completed the 2015-2019 National Survey of Drug Use and Health (unweighted N = 3,461). We used logistic regression models to test odds of 1) past-year SUD treatment need and 2) SUD treatment receipt among pregnant women. Models included age, race and ethnicity, income, education, marital status, sexual orientation, mental illness, and survey year as independent variables; interactions between income and racial/ethnic group were also included.

RESULTS

7.8% of pregnant women had a SUD and 1.2% (20% of those with treatment need) received SUD treatment. Unmarried, bisexual (vs heterosexual), non-Hispanic/Latina Black (vs non-Hispanic/Latina White), and women with mental illness showed increased odds of a SUD. An income by race interaction indicated Hispanic/Latina women of lower income were less likely to have SUD than White women of higher income. Of those with a treatment need, married women and women aged 18-25 (vs 26-34 and 35+) had lower odds of receiving treatment.

CONCLUSION

SUD treatment need differed among pregnant women by marital status, sexual orientation, race and ethnicity, and mental illness, as did treatment receipt by marital status and age. Specialized outreach and engagement strategies are needed to ensure equitable access to SUD treatment during pregnancy.