Medication for Opioid Use Disorder During Pregnancy - Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021.

IF 37.3 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Kathryn Miele, Shin Y Kim, Rachelle Jones, Juneka H Rembert, Elisha M Wachman, Hira Shrestha, Michelle L Henninger, Teresa M Kimes, Patrick D Schneider, Vaseekaran Sivaloganathan, Katherine A Sward, Vikrant G Deshmukh, Pilar M Sanjuan, Jessie R Maxwell, Neil S Seligman, Sarah Caveglia, Judette M Louis, Tanner Wright, Carolyne Cody Bennett, Caitlin Green, Nisha George, Lucas Gosdin, Emmy L Tran, Dana Meaney-Delman, Suzanne M Gilboa
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引用次数: 0

Abstract

Problem: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.

Period covered: 2014-2021.

Description of the system: Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites in 2019. In 2021, three clinical sites were added to the network (the University of New Mexico, the University of Rochester, and the University of South Florida). Persons receiving care at the seven clinical sites are diverse in terms of geography, urbanicity, race and ethnicity, insurance coverage, and type of MOUD received. The goal of MAT-LINK is to capture demographic and clinical information about persons with OUD during pregnancy to better understand the effect of MOUD on outcomes and, ultimately, provide information for clinical care and public health interventions for this population. MAT-LINK maintains strict confidentiality through robust information technology architecture. MAT-LINK surveillance methods, population characteristics, and evaluation findings are described in this inaugural surveillance report. This report is the first to describe the system, presenting detailed information on funding, structure, data elements, and methods as well as findings from a surveillance evaluation. The findings presented in this report are limited to selected demographic characteristics of pregnant persons overall and by MOUD treatment status. Clinical and outcome data are not included because data collection and cleaning have not been completed; initial analyses of clinical and outcome data will begin in 2023.

Results: The MAT-LINK surveillance network gathered data on 5,541 reported pregnancies with a known pregnancy outcome during 2014-2021 among persons with OUD from seven clinical sites. The mean maternal age was 29.7 (SD = ±5.1) years. By race and ethnicity, 86.3% of pregnant persons were identified as White, 25.4% as Hispanic or Latino, and 5.8% as Black or African American. Among pregnant persons, 81.6% had public insurance, and 84.4% lived in urban areas. Compared with persons not receiving MOUD during pregnancy, those receiving MOUD during pregnancy were more likely to be older and White and to have public insurance. The evaluation of the surveillance system found that the initial four clinical sites were not representative of demographics of the South or Southwest regions of the United States and had low representation from certain racial and ethnic groups compared with the overall U.S. population; however, the addition of three clinical sites in 2021 made the surveillance network more representative. Automated extraction and processing improved the speed of data collection and analysis. The ability to add new clinical sites and variables demonstrated the flexibility of MAT-LINK.

Interpretation: MAT-LINK is the first surveillance system to collect comprehensive, longitudinal data on pregnant person-infant dyads with perinatal outcomes associated with MOUD during pregnancy from multiple clinical sites. Analyses of clinical site data demonstrated different sociodemographic characteristics between the MOUD and non-MOUD treatment groups.

Public health actions: MAT-LINK is a timely and flexible surveillance system with data on approximately 5,500 pregnancies. Ongoing data collection and analyses of these data will provide information to support clinical and public health guidance to improve health outcomes among pregnant persons with OUD and their children.

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妊娠期阿片类药物使用紊乱--了解妊娠期阿片类药物使用紊乱相关结果的母婴网络(MAT-LINK),2014-2021 年。
问题:建议妊娠期阿片类药物使用障碍(OUD)患者服用治疗阿片类药物使用障碍(MOUD)的药物。然而,关于孕期阿片类药物使用障碍管理的最佳实践还存在知识差距,需要这些数据来指导临床护理:了解孕期阿片类药物使用障碍相关结果的母婴网络(MAT-LINK)成立于 2019 年,是一个由美国 7 个临床站点组成的监测网络。波士顿医疗中心、西北凯撒医疗集团、俄亥俄州立大学和犹他大学是 2019 年的首批临床基地。2021 年,该网络又增加了三个临床站点(新墨西哥大学、罗切斯特大学和南佛罗里达大学)。在这七个临床基地接受治疗的人在地理位置、城市化程度、种族和民族、保险覆盖率以及接受的 MOUD 类型等方面各不相同。MAT-LINK 的目标是收集孕期 OUD 患者的人口统计和临床信息,以便更好地了解 MOUD 对治疗效果的影响,最终为这一人群的临床治疗和公共卫生干预提供信息。MAT-LINK 通过强大的信息技术架构严格保密。MAT-LINK 监测方法、人群特征和评估结果将在这份首次监测报告中进行介绍。本报告是第一份描述该系统的报告,详细介绍了该系统的资金、结构、数据元素和方法,以及监测评估结果。本报告中介绍的结果仅限于孕妇的总体人口统计特征和 MOUD 治疗状况。由于数据收集和清理工作尚未完成,因此不包括临床和结果数据;临床和结果数据的初步分析将于 2023 年开始:MAT-LINK监测网络收集了2014-2021年期间来自7个临床站点的5,541例已知妊娠结果的OUD患者的妊娠报告数据。产妇的平均年龄为 29.7 岁(SD = ±5.1)。按种族和民族划分,86.3% 的孕妇被认定为白人,25.4% 被认定为西班牙裔或拉丁裔,5.8% 被认定为黑人或非裔美国人。在孕妇中,81.6%有公共保险,84.4%居住在城市地区。与怀孕期间未接受钼靶治疗的人相比,怀孕期间接受钼靶治疗的人更有可能是老年人、白人和有公共保险的人。对监测系统的评估发现,最初的四个临床站点不能代表美国南部或西南部地区的人口构成,与美国总人口相比,某些种族和民族群体的代表性较低;然而,2021 年新增的三个临床站点使监测网络更具代表性。自动提取和处理提高了数据收集和分析的速度。MAT-LINK能够增加新的临床站点和变量,这充分体现了MAT-LINK的灵活性:MAT-LINK是首个从多个临床站点收集与妊娠期MOUD相关的围产期结局的孕妇-婴儿二人组综合纵向数据的监测系统。对临床地点数据的分析表明,MOUD 治疗组和非 MOUD 治疗组之间存在不同的社会人口特征:公共卫生行动:MAT-LINK 是一个及时、灵活的监测系统,拥有约 5,500 例妊娠的数据。持续的数据收集和分析将为临床和公共卫生指导提供信息支持,以改善患有 OUD 的孕妇及其子女的健康状况。
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来源期刊
Mmwr Surveillance Summaries
Mmwr Surveillance Summaries PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
60.50
自引率
1.20%
发文量
9
期刊介绍: The Morbidity and Mortality Weekly Report (MMWR) Series, produced by the Centers for Disease Control and Prevention (CDC), is commonly referred to as "the voice of CDC." Serving as the primary outlet for timely, reliable, authoritative, accurate, objective, and practical public health information and recommendations, the MMWR is a crucial publication. Its readership primarily includes physicians, nurses, public health practitioners, epidemiologists, scientists, researchers, educators, and laboratorians.
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