Author Credentials

Melissa Nehls MD


Pregnancy, substance use disorder, substance abuse, complications, inpatient, admission


Medicine and Health Sciences



In recent times, there has been an increase in drug abuse in the general population and in women of reproductive age. Our objectives were to identify, classify, and describe the spectrum of complications, the average number of admissions, and the length of hospital stay among pregnant women with substance abuse. The aim was to understand complication prevalence better to improve management in this ever-growing population.


A retrospective chart review was conducted of pregnant women ages 18-45 with a history of substance abuse from 2013-2018 in the tri-state area of West Virginia, Ohio, and Kentucky. We collected the following data: demographics, medical history, specific substances abused, inpatient admission dates and diagnoses, and delivery information. A total of 411 patients met the inclusion criteria, comprising 525 pregnancies.


Out of 525 pregnancies, 71.6 % used buprenorphine (i.e., Subutex), 43.4% used opiates (excluding heroin), and 35% of patients used heroin. Out of the 525 pregnancies, there were 714 inpatient antepartum admissions. Of these, 376 were admissions due to withdrawal symptoms (52.7%). A total of 263 pregnancies had at least one admission for withdrawal, drug abuse, overdose, or buprenorphine/methadone conversion (50%). The average hospital stay for withdrawal admissions was 3.4 days (SD). There were 62 admissions for infectious causes, 24 due to pyelonephritis (38.7%).


The findings highlight multiple areas for future studies and areas for quality improvement in managing this population.