{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:36:07Z","timestamp":1792416967905,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["1U38OT000143\u201004"],"award-info":[{"award-number":["1U38OT000143\u201004"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K24DK105989"],"award-info":[{"award-number":["K24DK105989"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K12DA043490"],"award-info":[{"award-number":["K12DA043490"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA048169"],"award-info":[{"award-number":["K23DA048169"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Opioid\u2010related overdose is increasingly linked to pregnancy\u2010associated deaths, but factors associated with postpartum overdose are unknown. We aimed to estimate the strength of the association between maternal and infant characteristics and postpartum opioid\u2010related overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using a linked, population\u2010level data set.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Massachusetts, United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among women who delivered live infants in Massachusetts, USA between 2012 and 2014, maternal diagnosis of OUD, prior non\u2010fatal overdose, infant diagnosis of NAS and high unscheduled health\u2010care utilization appeared to be positively associated with postpartum opioid overdose. However, more than half of postpartum overdoses in that period were to women without a diagnosis of OUD. Engagement in methadone or buprenorphine treatment in the month prior to delivery was not sufficient to reduce the odds of postpartum overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Women who delivered one or more live births from 2012 to 2014 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0174\u2009517).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The primary outcome was opioid\u2010related overdose in the postpartum year. We used multivariable logistic regression to explore the independent associations of maternal (demographics, substance use, pregnancy) and infant [gestational age, birthweight, neonatal abstinence syndrome (NAS)] characteristics with postpartum opioid overdose. Findings were stratified by maternal opioid use disorder (OUD) diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      There were 189 deliveries to women who experienced \u2265\u00a01 opioid overdose in the first year postpartum (11 of 10\u2009000 deliveries). Among women with postpartum opioid overdose, 46.6% had an OUD diagnosis within 12\u00a0months before delivery. In our adjusted model, maternal diagnosis of OUD [adjusted odds ratio (aOR)\u00a0=\u00a03.61, 95% confidence interval (CI)\u00a0=\u00a01.73\u20137.51] and prior non\u2010fatal overdose (aOR\u00a0=\u00a02.40, 95% CI\u00a0=\u00a01.11\u20135.17) were most strongly associated with postpartum overdose. After stratifying by OUD status, infant diagnosis of NAS (OUD\n                      <jats:sup>+<\/jats:sup>\n                      aOR\u00a0=\u00a02.03, 95% CI\u00a0=\u00a01.26\u20133.27; OUD\n                      <jats:sup>\u2013<\/jats:sup>\n                      aOR\u00a0=\u00a02.79, 95% CI\u00a0=\u00a01.12\u20136.93) and high unscheduled health\u2010care utilization (OUD\n                      <jats:sup>+<\/jats:sup>\n                      aOR\u00a0=\u00a02.27, 95% CI\u00a0=\u00a01.38\u20133.73; OUD\n                      <jats:sup>\u2013<\/jats:sup>\n                      aOR\u00a0=\u00a02.11, 95% CI\u00a0=\u00a01.24\u20133.58) were positively associated with postpartum overdose in both groups.\n                    <\/jats:p>\n                  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