The Maternal Opioid Morbidity Study (MOMS)

Purpose:  Overdose by “ingestion of drugs” is the second leading cause of maternal mortality in the state of Texas. Maternal mortality is defined by the Centers for Disease Control and Prevention as a death occurring during pregnancy or within the first 365 days following the end of a pregnancy. Maternal overdose death in Texas is second only to maternal deaths caused by a cardiac event. Case records (including postmortem toxicology and police reports) indicate that most of these deaths involved the use of licit or illicit prescription opioids. This is consistent with the nationwide increase in prescription overdose deaths, a major public health crisis. While these statistics are concerning, little is known about the context of maternal overdose death. The purpose of this two-year, exploratory study is to provide insight into the contextual factors that surround maternal opioid overdose deaths.

Methods: Qualitative data collection will begin in January of 2017. We will recruit women who have experienced an opioid use relapse and/or overdose, during the maternal period, from gender specific substance use disorders treatment programs. We will also recruit family members, friends and the significant others of women who have died of a maternal overdose. We will first conduct focus groups and individual interviews to guide the development of our interview guide. Following this, we will pilot test our interview guide with our population of interest. Year one data collection for this project will be complete by the end of August 2017. Our plan is to incorporate feedback from participants to hone our interview guide and possibly add survey and biological data collection during year two of this study.

Results:  To analyze the qualitative data from year one of this project, we will use thematic analysis. Two experienced qualitative researchers will first analyze the data independent of each other. Following this, we will discuss emerging themes until a consensus is reached. These themes will be incorporated into our interview guide to ensure the collection of rich qualitative and quantitative data in year two of this project.

Conclusion: Having a better understanding of the context and circumstances surrounding maternal overdose could help predict overdose death and contribute to the development of targeted interventions to prevent deaths in this vulnerable population of women.