Establishing a Baseline: Substance Use and Infant and Maternal Mortality

Substance use during pregnancy impacts people of all races, incomes, education and employment levels, across geographic regions, with young women and those living in poverty most deeply impacted. In Colorado, the state health department reported a 98% increase in newborns exposed to opioids prenatally between 2012-2018, and the Substance Abuse and Mental Health Services Administration estimates that prenatal exposure to alcohol or illicit drugs affects 10-11% of all births.

State health department data show that more than 75% of pregnancy-associated deaths in Colorado are preventable.

The perinatal substance use data linkage study (SB19-228 and SB21-137) aims to establish a comprehensive understanding of who is impacted by perinatal substance use disorders in Colorado, and why, and identify ways that family health and well-being can be safeguarded and improved through health care, prevention, and public benefit policies and practices.

A new study, Phase One Supplemental: Maternal & Infant Mortality in the First Year of Life, builds on last spring’s initial study focused on the risk of infant removal by child welfare shortly after a birth event due to a referral of substance exposure. The supplemental study establishes a baseline understanding of infant and maternal mortality outcomes for families in Colorado involved in child welfare and impacted by perinatal substance use.

Study findings show drug overdose as the leading cause of pregnancy-associated death for these mothers. The maternal death rate for this sample—mothers who were involved in child welfare and impacted by perinatal substance use between 2013-2019—was about 4% lower than the state average. As well, the infant mortality rate has continued to decline and is now below the state average for the most recent study years. These findings may indicate that families involved in child welfare receive more services and supports that meet their needs and contribute to these lower rates.

At the same time, state health department data show that more than 75% of pregnancy-associated deaths in Colorado are preventable. Obtaining baseline data on mother-infant dyads impacted by perinatal substance use through this study and advancing the next phases of this project are critical to growing understanding and improving policies, systems, and services to prevent unnecessary deaths and strengthen the health and life path of Colorado mothers, infants, and families.

For more information on this and upcoming phases of the perinatal substance use data linkage study, visit ColoradoLab.org or contact Dr. Elysia Clemens.