PROMISE/OVAL

We propose to analyze data to calculate the prevalence and area-based correlates of hospital encounters for drug-related harms for two related, Emory IRB-Approved studies: Substance use in PRegnancy and the mOrbidity Mortality rISk Environment (PROMISE) and Overdoses Among Pregnant/Postpartum Women and Laws Governing Drug Use in Pregnancy: A Mixed-Methods Project (OVAL). The correlates include but are not limited to overdoses, injection-related abscesses, cellulitis, and endocarditis- among pregnant and postpartum people between 2016 and present. The PROMISE study is designed to understand patterns of drug-related morbidity and mortality among pregnant and postpartum people in the US and analyze the place-based correlates of these outcomes. We will achieve this purpose by analyzing existing administrative data (hospital discharge data, data from maternal mortality review committees, and multiple databases to describe the places where pregnant/postpartum people live). 
 

The OVAL study applies a mixed-methods sequential explanatory “QUAN qual” design to study the possible effects of 3 laws governing drug use in pregnancy on overdoses, SUD treatment use, and prenatal/ postnatal care use among women. The 3 laws are: (1) laws requiring that healthcare providers/social workers report pregnant women who use drugs to Child Protective Services; (2) laws that classify drug use in pregnancy as Child Abuse/Neglect; and (3) laws that prioritize pregnant women for SUD treatment. We focus on women on Medicaid, given higher rates of ODs and drug-related harms among impoverished people. OVAL is ultimately designed to optimize these laws’ benefits and mitigate their harms among pregnant/postpartum women.