Racial Disparities in Newborn Drug Testing After Implementation of Question-Based Screening for Prenatal Substance Use.

IF 8.3 2区 材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY
ACS Applied Materials & Interfaces Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI:10.1097/AOG.0000000000005631
Alexandra Soos, Melissa Plegue, Adam Darwiche, Lauren Oshman, Christopher J Frank
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引用次数: 0

Abstract

Objective: To examine the association of universal question-based screening for prenatal substance use on racial inequities in prenatal and newborn drug testing.

Methods: We conducted a retrospective cohort study of 32,802 live births of patients receiving prenatal care at an academic medical center in the midwestern United States from 2014 to 2022, before and after implementation of question-based screening in 2018. Primary outcomes included prenatal and newborn drug test orders. Logistic regression models using a generalized estimating equation framework assessed associations with question-based screening and results, birthing parent age, race, ethnicity, marital status, and insurance type. Charts of patients who indicated difficulties stopping substance use were audited for guideline-directed care.

Results: A total of 12,725 of 14,992 pregnant people (85.3%) received question-based screening. Implementation of question-based screening was associated with a decrease in prenatal urine test orders (5.0% [95% CI, 4.6-5.3%] before implementation, 3.1% [95% CI, 2.8-3.4%] after implementation; P <.001), with Black birthing parents having the largest reduction in prenatal urine drug testing (10.3% [95% CI, 9.0-11.7%] before implementation, 4.9% [95% CI, 3.9-5.9%] after implementation). However, rates of newborn drug testing did not change (4.7% [95% CI, 4.4-5.0%] before implementation, 4.5% [95% CI, 4.2-4.8%] after implementation; P =.46), and clinicians continued to order significantly more newborn drug tests for newborns of Black birthing parents compared with other race and ethnicity groups.

Conclusion: Implementation of question-based screening for substance use in pregnancy was associated with decreased prenatal urine drug testing but no change in overall newborn drug testing or racial inequities in newborn drug testing for Black birthing people. Further policy efforts are warranted to improve substance use treatment and to eliminate racial inequities in punitive policies such as newborn drug testing and subsequent child protective services reporting.

实施基于问题的产前药物使用筛查后新生儿药物检测中的种族差异。
目的研究基于问题的产前药物使用普遍筛查与产前和新生儿药物检测中种族不平等的关系:我们对 2014 年至 2022 年期间在美国中西部一家学术医疗中心接受产前护理的 32802 名活产儿,在 2018 年实施基于问题的筛查之前和之后进行了一项回顾性队列研究。主要结果包括产前和新生儿药物测试订单。使用广义估计方程框架的逻辑回归模型评估了基于问题的筛查与结果、分娩父母年龄、种族、民族、婚姻状况和保险类型之间的关联。对表示难以停止使用药物的患者的病历进行了审核,以获得指导性护理:在 14992 名孕妇中,共有 12725 人(85.3%)接受了基于问题的筛查。基于问题的筛查的实施与产前尿检单的减少有关(实施前为 5.0% [95% CI, 4.6-5.3%],实施后为 3.1% [95% CI, 2.8-3.4%];PC结论:基于问题的孕期药物使用筛查的实施与产前尿液药物检测的减少有关,但新生儿药物检测的总体情况或黑人新生儿药物检测的种族不平等情况没有发生变化。需要进一步制定政策,改善药物使用治疗,消除新生儿药物检测和随后的儿童保护服务报告等惩罚性政策中的种族不平等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Materials & Interfaces
ACS Applied Materials & Interfaces 工程技术-材料科学:综合
CiteScore
16.00
自引率
6.30%
发文量
4978
审稿时长
1.8 months
期刊介绍: ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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