Associations between state-level prenatal substance use policies and treatment completion among pregnant women admitted to substance use treatment facilities.
Substance use during pregnancy poses significant risks to maternal and neonatal health, yet less than half of pregnant women with substance use disorders (SUDs) receive appropriate treatment. State-level prenatal substance use policies may influence treatment outcomes, but their impact on treatment completion remain understudied. This study examines how criminal justice, provider reporting, and treatment support policies are associated with substance use treatment completion among pregnant women.
We analyzed data from the Treatment Episode Data Set-Discharge (TEDS-D) for pregnant women aged 12 or older who were admitted to publicly funded substance use treatment facilities between 2020 and 2022 in the United States (n = 38,410). Multivariable-adjusted logistic regression models were used to assess associations between state-level prenatal substance use policies and treatment completion, adjusting for other covariates.
About 29.5% of pregnant women completed treatment. Women in states with criminal justice policies had a higher likelihood of treatment completion (adjusted odds ratio [AOR], 1.23; 95% confidence interval [CI], 1.13-1.34; p < 0.001), as did those in states with treatment support services (AOR, 1.14; 95% CI, 1.03-1.28; p = 0.014). Conversely, those in states with provider reporting mandates had a lower likelihood of treatment completion (AOR, 0.49; 95% CI, 0.36-0.67; p < 0.001).
State-level prenatal substance use policies are associated with treatment completion among pregnant women. While criminal justice and supportive treatment policies may enhance treatment completion, mandatory provider reporting requirements may deter retention. These findings underscore the importance of designing policies that foster trust, reduce stigma, and prioritize access and engagement for pregnant women.
We analyzed data from the Treatment Episode Data Set-Discharge (TEDS-D) for pregnant women aged 12 or older who were admitted to publicly funded substance use treatment facilities between 2020 and 2022 in the United States (n = 38,410). Multivariable-adjusted logistic regression models were used to assess associations between state-level prenatal substance use policies and treatment completion, adjusting for other covariates.
About 29.5% of pregnant women completed treatment. Women in states with criminal justice policies had a higher likelihood of treatment completion (adjusted odds ratio [AOR], 1.23; 95% confidence interval [CI], 1.13-1.34; p < 0.001), as did those in states with treatment support services (AOR, 1.14; 95% CI, 1.03-1.28; p = 0.014). Conversely, those in states with provider reporting mandates had a lower likelihood of treatment completion (AOR, 0.49; 95% CI, 0.36-0.67; p < 0.001).
State-level prenatal substance use policies are associated with treatment completion among pregnant women. While criminal justice and supportive treatment policies may enhance treatment completion, mandatory provider reporting requirements may deter retention. These findings underscore the importance of designing policies that foster trust, reduce stigma, and prioritize access and engagement for pregnant women.