Available online 22 January 2023

To examine the psychometric properties of the Prenatal Opioid Use Perceived Stigma (POPS) scale and to assess the relationship of POPS scores to adequate prenatal care.

Prospective cohort study.

Medical centers in Alabama, Ohio, and Pennsylvania (N = 4).

Women (N = 127) who took opioids during pregnancy and whose infants participated in the Outcomes of Babies With Opioid Exposure Study.

Participants reported their perceptions of stigma during pregnancy by responding to the eight items on the POPS scale. We evaluated the instrument’s internal consistency reliability (Cronbach’s alpha), structural validity (factor analysis), and convergent validity (relationship with measures of similar constructs). In addition, to assess construct validity, we used logistic regression to examine the relationship of POPS scores to the receipt of adequate prenatal care.

The internal consistency of the POPS scale was high (Cronbach’s α = .88), and all item-total correlations were greater than 0.50. The factor analysis confirmed that the items cluster into one factor. Participants who reported greater perceived stigma toward substance users and everyday discrimination in medical settings had higher POPS scores, which supported the convergent validity of the scale. POPS scores were significantly associated with not receiving adequate prenatal care, adjusted OR = 1.47, 95% confidence interval [1.19, 1.83], p < .001.

The psychometric testing of the POPS scale provided initial support for the reliability and validity of the instrument. It may be a useful tool with which to assess perceived stigma among women who take opioids, a potential barrier to seeking health care during pregnancy.

delivery of health care

opioid-related disorders

prenatal drug exposure

pregnancy

pregnant women

prenatal care

psychometrics

scale development

social stigma

stigma

Carla M. Bann, PhD, is a senior fellow, Division for Statistical and Data Sciences, RTI International, Research Triangle Park, NC.

Jamie E. Newman, PhD, MPH, is a senior research public health analyst, Analytics Division, RTI International, Research Triangle Park, NC.

Katherine C. Okoniewski, PhD, is a research public health analyst, Genomics, Ethics, and Translational Research Center, RTI International, Research Triangle Park, NC.

Leslie Clarke, RN, MS, MBA, is a research nurse, Department of Pediatrics, Case Western Reserve University, Cleveland, OH.

Deanne Wilson-Costello, MD, is the Director of Neonatology Services, Case Western Reserve University, Cleveland, OH.

Stephanie Merhar, MD, MS, is an associate professor, Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Nicole Mack, MS, is a research statistician, Division for Statistical and Data Sciences, RTI International, Research Triangle Park, NC.

Sara DeMauro, MD, MSCE, is an associate professor of pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA.

Scott Lorch, MD, MSCE, is the Associate Chief of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA.

Namasivayam Ambalavanan, MD, is the Director of the Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.

Catherine Limperopoulos, PhD, is the Chief and Director, Developing Brain Institute Director of Research, Prenatal Pediatrics Institute, Children’s National Medical Center, Washington, DC.

Brenda Poindexter, MD, is the Division Chief of Neonatology, Emory University, Atlanta, GA.

Michele Walsh, MD, is a program officer, Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.

Jonathan M. Davis, MD, is the Vice-Chair of Pediatrics and the Chief of Newborn Medicine, Tufts Medical Center, Boston, MA.

© 2022 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc.