July 2018 Epi Bulletin
Medication use during pregnancy

Opioid Medication Use in Women

The opioid epidemic is a national and public health issue. While the opioid epidemic affects the entire country, it’s important to note the impact on women of childbearing age (15-44 years) because of the maternal, infant, child and family health issues associated with this group. Taking opioid medication early in pregnancy has been shown to cause serious health problems both for the mother and the infant. Some women may not know that they are pregnant in the initial period of their first trimester, and studies have shown that each year from 2008 to 2012 more than a third of the reproductive-aged women enrolled in Medicaid, and more than a quarter of those with private insurance, filled a prescription for an opioid pain medication.

More awareness and understanding of the impacts of women's drug use on the maternal, infant, child and the overall family health may encourage more collaboration in working with women to minimize most of the preventable exposures of pregnant women to opioid prescription medications.

Women need to know that:

Mothers with pregnancies affected by neural tube disorder (NTD) reported opioid use more often during the first two months of pregnancy than mothers of babies without an NTD. 3

Mothers who were treated with opioid medicines during the first trimester (first three months) of pregnancy were twice as likely to have a pregnancy affected by spina bifida than mothers who didn’t use opioids during the first trimester. 4

Maternal opioid use during pregnancy was also associated with pregnancy-related maternal/fetal morbidity and mortality. 5

Opioid dependent mothers are more likely to lack healthy nutritional habits, have inadequate prenatal care and engaged in risky sexual practices. 5

Opioid dependent mothers were more likely to have other comorbidities, including depression, anxiety, insomnia, diabetes, hypertension, renal diseases, and HIV infection. 5

Opioid dependent mothers are more likely to have an infant with neonatal abstinence syndrome (NAS). This is a drug withdrawal syndrome that most commonly occurs in infants after exposure to opioids in their mothers' womb, although other substances have also been associated with the syndrome. 2 NAS leads to prolonged neonatal hospitalizations, which in turn increase overall hospital costs among these mothers and their infants. 5

Children living with at least one parent with substance use disorder (SUD) are also more likely to have higher rates of mental and behavioral disorders. Also, these children are more likely to develop SUD symptoms themselves.6

The diseases in persons who are addicted to drugs are more likely to affect their close family members. 6

For information to help in education and awareness of effects of opioid medication use among women click here.


A toddler eating an apple

2019-2020 MCHC Work Plan

The Clay County Public Health Center would like to share the executive summary of the 2019-2020 Maternal Child Health Contract (MCHC) Implementation Plan with partners. Please click here to access the plan. For background information on the  Clay County Program supporting the contract click here


Progression of TB disease

Updated Recommendations for Latent Tuberculosis Treatment 

In 2011, the Centers for Disease Control and Prevention (CDC) recommended a short-course combination regimen of once-weekly isoniazid and rifapentine for twelve weeks by directly observed therapy for treatment of latent tuberculosis infection (LTBI). This treatment regime was limited to those who are over the age of 12 and those who are HIV negative.

Recently, this recommendation was updated, and this treatment regimen can also be used for the  treatment of LTBI patients ages two and older and patients with HIV infection, including AIDS. The recommendations have also been updated to allow for use in both directly observed therapy and self-observed therapy. For more information on this recommendation click here.

Clay County Communicable Disease Data Summary

The 2018 year-to-date disease report for MMWR Week 24 shows that most reportable disease conditions remained within what is expected for the county, except for enteric diseases namely: camplylobacteriosis, giardiasis and salmonellosis. Also, other disease that are above what is expected among Clay County residents are streptococcus pneumonia invasive disease and tick-borne diseases which are beginning to show increase. The Clay County Public Health Center continues to emphasize the importance of good hand hygiene, good sanitary practice and safe food handling practice in the control of enteric illnesses. Also, we encourage citizens to take necessary steps to prevent tick and mosquito bites.

To learn more on tick-borne diseases and ways to protect yourself click here.

May/June 2018 Communicable Disease Data

To view the chart of communicable disease data, click here.

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