At a glance
CDC developed five strategic priorities aimed to prevent opioid-related overdoses and associated harms. To support this strategy, the Division of Reproductive Health took action to better understand prescription opioid use among pregnant and postpartum women.
Overview
Existing surveillance infrastructure using the Pregnancy Risk Assessment Monitoring System (PRAMS) and other maternal-infant health surveys were used to address one component of the five strategic priorities. CDC funded 2 PRAMS-related opioid surveillance activities in 2019.
- The PRAMS Opioid Supplement collected information on prescription opioid pain reliever use during pregnancy.
- The supplement was implemented in 32 PRAMS sites and 2 non-PRAMS sites for a total of 34 sites.
- The PRAMS Opioid Call-back Survey was conducted to learn about prescription opioid pain reliever use, substance use treatment postpartum, and infant health from PRAMS survey respondents 9–10 months after a live birth. The Call-back Survey was implemented in 7 PRAMS sites with high rates of opioid-related overdoses.
Participating Jurisdictions
Jurisdictions Participating in the Pregnancy Risk Assessment Monitoring System (PRAMS), Opioid Supplement and Opioid Call-back Survey, 2019.
Part 1: Opioid Supplement
A total of 32 PRAMS jurisdictions received funding to implement the Opioid Supplement. Two additional sites with maternal-infant health surveys, California (Maternal and Infant Health Assessment) and Ohio (Ohio Pregnancy Assessment Survey), were funded through a partnership with the CDC Foundation to implement the Opioid Supplement.
Overview and Methods
Jurisdictions included the supplemental questions at the end of their PRAMS or maternal-infant surveys.
Questionnaire
The Opioid Supplement included a total of 10 questions, taking approximately 5–10 minutes to complete, and collected data on maternal knowledge, behaviors, and experiences related to prescription opioid use during pregnancy.
Copies of the Opioid Supplement can be found on the PRAMS Questionnaires web page.
Part 2: Opioid Call-back Survey
Overview and Methods
Seven sites with a high rate of opioid-related overdose deaths, which participated in the Opioid Supplement, implemented the Opioid Call-back Survey from October 2019 to April 2020. Each site designed a sampling plan to oversample women in areas of the state with populations at increased risk of opioid overdose.
Women were contacted to complete the Opioid Call-back Survey if they completed the regular PRAMS survey and did not decline participating in the call-back. Women were contacted when the infant was 9 months old and were eligible to complete the survey until their infant was 10 months old.
Questionnaire
The Opioid Call-back Survey had a total of 58 questions and took approximately 35 minutes to complete. It assessed opioid misuse and access to medication-assisted therapy, satisfaction with care received, postpartum care received, infant health and development, and receipt of social services and supports.
Copies of the Opioid Call-back Survey can be accessed below:
Publications
Ko JY, D'Angelo DV, Haight SC, et al. Vital Signs: Prescription Opioid Pain Reliever Use During Pregnancy — 34 U.S. Jurisdictions, 2019. MMWR Morb Mortal Wkly Rep. 2020;69:897–903.
Requesting Data
Data from the Opioid Supplement and Opioid Call-back Survey are available. To request Opioid Supplement data, please follow instructions on the PRAMS Data web page. To request Opioid Call-back Survey data for analysis, please contact the PRAMS proposal mailbox.