Black women experience high likelihood of urine toxicology testing at delivery

Key takeaways :

• Black women had higher probability of urine toxicology testing vs. women of other racial groups.
• Probability of positive urine toxicology tests was higher among white vs. Black women with substance use history.

Black women had a greater probability of undergoing urine toxicology testing at delivery compared with other racial groups regardless of substance use history, researchers reported in JAMA Health Forum.

Marian Jarlenski, PhD, MPH, associate professor in the department of health policy and management at the University of Pittsburgh School of Public Health, and colleagues conducted a cohort study of 37,860 women (mean age, 29.8 years) with live or stillbirth delivery between March 2018 and June 2021 in a large health care system in Pennsylvania. Researchers verbally screened all women presenting for delivery for substance use and performed policy-specified urine toxicology testing for those with a positive screen result, substance use history in the year before delivery, few prenatal visits or abruption or stillbirth without a medical explanation.

In the cohort, 16% of women were Black, 76% were white and 8% were of another race; 11% of women had substance use history, with opioid use the most common among white women (40%) and cannabis use the most common among Black women (86%).

Black women had the highest mean predicted probability of urine toxicology testing compared with white women and women of other racial groups regardless of substance use history. Black women without substance use history had a higher mean predicted probability of receiving urine toxicology testing at delivery compared with white women (6.9% vs. 4.7%). Black women with substance use history had a mean predicted probability of 76.4% compared with 68.7% among white women.

The mean predicted probability of having a positive urine toxicology test result was 66.7% among white women with substance use history and 58.3% among Black women with substance use history.

“To address racial biases, health care systems should examine drug testing practices and adhere to evidence-based practices,” the researchers wrote.