Society for Maternal-Fetal Medicine Special Statement: Guidance to reduce racial disparities in substance use screening and biological testing in pregnancy at the delivery admission
SMFM, JJM Cate, ST Bauer, NR Chavan, M Parrish, J Peterson, D Goffman, C Davidson, SMFM Patient Safety and Quality Committee2026
The American Society of Addiction Medicine supports this document.
Substance use complicates upward of 10% of US pregnancies. The Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynecologists, and the American Society of Addiction Medicine have jointly recommended universal screening for substance use during pregnancy using a validated tool, without recommending universal biological testing. Despite this recommendation, racial and ethnic differences in substance use screening and biological testing occur, representing disparate care and a quality gap. This Special Statement from the Society for Maternal-Fetal Medicine introduces a comprehensive strategy, grounded in principles of quality improvement, to address racial and ethnic disparities in substance use screening, with an emphasis on equitable and respectful care. Additionally, we propose a quality metric expressed as the percentage of patients who were screened for a substance use disorder using a validated tool during birth hospitalization, stratified by race, ethnicity, preferred language, and payor status. This quality metric and other related metrics could serve as the basis for quality improvement projects aimed at reducing racial disparities in substance use screening.
Substance use complicates upward of 10% of US pregnancies. The Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynecologists, and the American Society of Addiction Medicine have jointly recommended universal screening for substance use during pregnancy using a validated tool, without recommending universal biological testing. Despite this recommendation, racial and ethnic differences in substance use screening and biological testing occur, representing disparate care and a quality gap. This Special Statement from the Society for Maternal-Fetal Medicine introduces a comprehensive strategy, grounded in principles of quality improvement, to address racial and ethnic disparities in substance use screening, with an emphasis on equitable and respectful care. Additionally, we propose a quality metric expressed as the percentage of patients who were screened for a substance use disorder using a validated tool during birth hospitalization, stratified by race, ethnicity, preferred language, and payor status. This quality metric and other related metrics could serve as the basis for quality improvement projects aimed at reducing racial disparities in substance use screening.