Date of Conferral

3-24-2026

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Claudia Kozinetz

Abstract

The rising trend of opioid-involved overdose deaths among pregnant and postpartum women in the United States from 2019 to 2023 represents a pressing public health issue. This population faces increasing risk due to opioid use and co-occurring mental health conditions, yet remains underrepresented in research. The purpose of this quantitative study was to examine the association between opioid involvement among pregnancy-associated overdose deaths, while controlling for pandemic periods (pre-COVID: 2019, peak COVID: 2020–2021, post-peak COVID: 2022–2023). Grounded in the syndemic theory, this study addressed two research questions Grounded in syndemic theory, this study addressed two research questions focused on opioid-involved pregnancy-associated mortality and its relationship with pandemic period, geographic region, age group, and diagnosed mental health conditions. Using secondary data from the Centers for Disease Control and Prevention’s National Center for Health Statistics, logistic regression was applied to assess associations between selected risk factors and opioid involvement among maternal overdose deaths. Results indicated that opioid involvement accounted for approximately 71% of pregnancy-associated overdose deaths from 2019–2023; however, pandemic period was not significantly associated with opioid involvement when controlling for other factors. Significant associations were observed by geographic region and age group, while diagnosed mental health conditions were not significantly associated with opioid involvement. These findings may inform clinical practice and policy efforts to reduce substance use and mental health-related maternal mortality and support more equitable, evidence-based care for pregnant and postpartum women.

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