Preterm Birth Among Opioid-Using Women and High-Risk Controls: The Potential Moderating Role of Borderline Features

Opioid use is a growing problem within this country (Maeda, Bateman, Clancy, Creanga, & Leffert, 2014). One implication of this is an increased incidence of preterm birth, defined as birth before 37 weeks gestation (Kramer et al., 2000; Norwitz & Robinson, 2001). Previous research supports an association between opioid use and preterm birth (Nørgaard, Nielsson, & Heide-Jørgensen, 2015). No research has evaluated the role mental health diagnoses aside from anxiety and depression (Benningfield et al., 2010) play in conjunction with opioid use in exacerbating the risk of preterm birth. In the proposed study, the focus is on Borderline Personality Disorder (BPD). BPD is a severe and chronic disorder that can be assessed with a categorical diagnosis or along a continuum of self-reported features (affective instability, identity disturbance, presence of negative relationships, and self-harm/impulsivity; Morey, 1991). While research suggests that BPD features are associated with opioid use (Kurdziel-Adams et al., in press), no research has evaluated how borderline features may relate to the relationship between opioid use and preterm birth and may serve to exacerbate the biological risks presented by opioid use. Results suggest that BPD (operationalized as >38 self-reported BPD features) predicts preterm birth; however, this relationship does not hold true when the variables are conceptualized continuously as borderline features and gestational age at birth. Furthermore, participants who used opioids during pregnancy were not more likely to give birth preterm than controls, who were women who had high-risk pregnancies for reasons aside from substance use. Additionally, BPD did not serve as a moderator between opioid use and preterm birth.