Accuracy of the Drug-Dependency Checkbox on the Maine Birth Certificate for Medicaid-covered Births, 2016-2020

Authors

Julia Dudley BA, University of Southern Maine, Muskie School of Public HealthFollow
Catherine McGuire BS, University of Southern Maine, Cutler InstituteFollow
Apsara Kumarage BA, University of Southern Maine, Cutler InstituteFollow
Chinonye Anumaka MPH, University of Southern Maine, Cutler InstituteFollow
Katherine Ahrens PhD, University of Southern Maine, Muskie School of Public HealthFollow

Submission Type

Original Research

Abstract

Introduction: The accuracy of the drug-dependency checkbox on Maine birth certificates is unknown. Our objective was to compare the drug-dependency checkbox with information on substance use disorders (SUDs) documented in Medicaid claims.

Methods: Using rule-based deterministic matching, we linked Medicaid enrollment information to Maine birth-record data between 2016 and 2020 (N = 58 584). Among the linked records (n = 27 448), we identified maternal SUD diagnoses during the 280 days before through 7 days after delivery using ICD-CM-9/10 diagnosis codes. We used the following hierarchy to create mutually exclusive SUD categories: opioid use disorder (OUD), cannabis use disorder without cocaine use disorder, and other SUD disorders (alcohol, cocaine, nicotine, or other).

Results: Among women enrolled in Medicaid at the time of delivery, 12% had drug dependency indicated on their birth record and 34% had at least one SUD diagnosis recorded in their Medicaid claims. Among birth records with drug dependency indicated, 56% indicated OUD, 26% indicated cannabis use disorder without cocaine use disorder, 8% indicated other SUD, and 10% indicated no SUD. Among those without drug dependency indicated, the corresponding percentages were 4% for OUD, 9% for cannabis use disorder, 14% for other SUD, and 74% for no SUD.

Discussion: Although diagnoses of OUD and cannabis use disorder were more common among birth records with a checked drug-dependency checkbox, reporting of drug dependency on birth records does not appear to accurately indicate SUD during pregnancy.

Conclusions: Our findings suggest that the drug-dependency checkbox on Maine birth certificates may have limited value in identifying SUD during pregnancy.

Recommended Citation

Dudley, Julia BA; McGuire, Catherine BS; Kumarage, Apsara BA; Anumaka, Chinonye MPH; and Ahrens, Katherine PhD (2023) "Accuracy of the Drug-Dependency Checkbox on the Maine Birth Certificate for Medicaid-covered Births, 2016-2020," Journal of Maine Medical Center: Vol. 5 : Iss. 1 , Article 2.
Available at: https://doi.org/10.46804/2641-2225.1139