The number of pregnant women with opioid use disorder at labor and delivery more than quadrupled between 1999 and 2014, to 6.5 per 1,000 hospital births, according to a new analysis by the Centers for Disease Control and Prevention. State rates in 2014 varied widely, from 0.7 per 1,000 in Washington, D.C. to 48.6 per 1,000 in Vermont. The variance may reflect differences in opioid prescribing rates and illicit drug use as well as improved screening, diagnosis and treatment for OUD and neonatal abstinence syndrome, the report notes. “Even in states with the smallest annual increases, more and more women are presenting with opioid use disorder at labor and delivery,” said Wanda Barfield, M.D., director off CDC’s Division of Reproductive Health. “These state-level data can provide a solid foundation for developing and tailoring prevention and treatment efforts.” OUD during pregnancy has been associated with negative health outcomes for mothers and their babies, including maternal death, preterm birth, stillbirth and neonatal abstinence syndrome.