Risk of adverse infant outcomes associated with maternal mental health and substance use disorders.

IF 3.2 3区 医学 Q2 PSYCHIATRY
Clare C Brown, J Mick Tilford, Michael Thomsen, Benjamin C Amick, Keneshia Bryant-Moore, Horacio Gomez-Acevedo, Creshelle Nash, Jennifer E Moore
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引用次数: 0

Abstract

Purpose: This study aimed to evaluate the association of mental health and substance use disorders on the risk of adverse infant outcomes overall and by race/ethnicity and payer.

Methods: We used birth certificates (2017-2022; n = 125,071) linked with state-wide insurance claims (2016-2022; n = 7,583,488) to assess the risk of an adverse infant outcome (i.e., prematurity [< 37 weeks gestation] or low birthweight [< 2,500 g]) associated with "any mental health" or "any substance use" disorder overall, by race/ethnicity, and by payer using diagnoses during the 9 months of pregnancy. We additionally evaluated seven specific mental health conditions and four specific substance use disorders.

Results: The rate of having an adverse infant outcome was 13.4%. Approximately 21.5% of birthing individuals had a mental health condition, and 8.7% had a substance use disorder. We found increased adjusted risk of an adverse infant outcome associated with having a mental health condition overall (aRR: 1.28; 95%CI: 1.23-1.32) and for all racial/ethnic groups and payers. We additionally found increased risk associated with substance use disorder overall (aRR: 1.32; 95%CI: 1.25-1.40) and for White, Black, privately-covered, and Medicaid-covered individuals. There was increased risk associated with six of seven mental health and three of four substance use disorders.

Conclusions: Given the risk of adverse infant outcomes associated with mental health and substance use disorders across racial/ethnic groups and payers, our findings highlight the critical importance of policies and clinical guidelines that support early identification and treatment of a broad spectrum of mental health and substance use disorders throughout the perinatal period.

与产妇精神健康和药物使用失调有关的婴儿不良后果风险。
目的:本研究旨在评估精神健康和药物使用失调与婴儿不良结局风险的整体关联,以及不同种族/民族和付款人之间的关联:我们使用出生证明(2017-2022 年;n=125,071)与全州范围内的保险理赔(2016-2022 年;n=7,583,488)来评估婴儿不良结局(即早产[结果:婴儿不良结局发生率为 13.4%。约 21.5% 的分娩者患有精神疾病,8.7% 的分娩者患有药物使用障碍。我们发现,总体而言,患有精神疾病的婴儿出现不良结局的调整后风险增加(aRR:1.28;95%CI:1.23-1.32),而且所有种族/民族群体和支付者的风险都增加了。我们还发现,总体而言,药物使用障碍会增加风险(aRR:1.32;95%CI:1.25-1.40),白人、黑人、自费人群和医疗补助人群也会增加风险。七种精神疾病中的六种和四种药物使用障碍中的三种的风险都有所增加:鉴于不同种族/族裔群体和支付者的婴儿不良结局与精神健康和药物使用失调相关的风险,我们的研究结果凸显了在整个围产期支持早期识别和治疗各种精神健康和药物使用失调的政策和临床指南的重要性。
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来源期刊
Archives of Women's Mental Health
Archives of Women's Mental Health 医学-精神病学
CiteScore
8.00
自引率
4.40%
发文量
83
审稿时长
6-12 weeks
期刊介绍: Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.
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