围产期药物使用障碍:研究对不良妊娠结局的影响

IF 1.5 Q3 OBSTETRICS & GYNECOLOGY
Alexandra S. Ragsdale , Noor Al-Hammadi , Travis M. Loux , Sabel Bass , Justine M. Keller , Niraj R. Chavan
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引用次数: 0

摘要

目标在美国,尤其是在孕妇中,药物使用障碍日益受到关注。本研究采用美国全国范围内的妊娠住院病人样本,评估药物使用障碍对不良妊娠结局的影响,并阐明对每种不良妊娠结局的影响。研究设计对2016年至2020年美国医疗成本与利用项目全国住院病人样本中的妊娠住院病人进行横断面分析。研究使用《国际疾病分类--第 10 版》和诊断相关组代码来识别患有药物使用障碍和/或不良妊娠结局的妊娠相关住院分娩病例。通过倾向得分匹配和多元逻辑回归分析,预测有药物使用障碍和无药物使用障碍的妊娠住院患者发生不良妊娠结局的可能性。结果在 3,238,558 例住院病例中,有药物使用障碍的住院病例(35.6%)与无药物使用障碍的住院病例(25.1%,p < 0.001)相比,不良妊娠结局的发生率要高得多。在对社会人口协变量进行匹配和模型调整后,发现药物使用障碍是不良妊娠结局的独立预测因素[调整后的几率比(aOR)为 1.47,95% 置信区间(CI)为 1.45-1.49]。在基于不良妊娠结局类型的亚组分析中,暴露风险最大的是胎儿生长受限(aOR 1.96,95 % CI 1.91-2.01)、产前出血(aOR 1.79,95 % CI 1.73-1.85)和早产(aOR 1.65,95 % CI 1.62-1.68)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perinatal substance use disorder: Examining the impact on adverse pregnancy outcomes

Objective

Substance use disorder is a growing concern in the USA, especially among pregnant women. This study was undertaken to assess the impact of substance use disorder on adverse pregnancy outcomes using a nationwide sample of inpatient pregnancy hospitalizations in the USA, and to elucidate the influence on each type of adverse pregnancy outcome.

Study design

A cross-sectional analysis of inpatient pregnancy hospitalizations in the USA from the Healthcare Cost and Utilization Project National Inpatient Sample from 2016 to 2020 was conducted. International Classification of Diseases – 10th revision and diagnosis-related group codes were used to identify inpatient pregnancy-related delivery hospitalizations with a substance use disorder and/or adverse pregnancy outcomes. Propensity score matching and multiple logistic regression analyses were undertaken to predict the likelihood of adverse pregnancy outcomes among pregnancy hospitalizations with and without substance use disorder. Subgroup analyses were performed to estimate the impact of substance use disorder on each adverse pregnancy outcome.

Results

From 3,238,558 hospitalizations, the prevalence of adverse pregnancy outcomes was substantially higher among pregnancy hospitalizations with substance use disorder (35.6 %) compared with pregnancy hospitalizations without substance use disorder (25.1 %, p < 0.001). After matching and model adjustment for sociodemographic covariates, substance use disorder was identified as an independent predictor of adverse pregnancy outcomes [adjusted odds ratio (aOR) 1.47, 95 % confidence interval (CI) 1.45–1.49]. In subgroup analyses based on type of adverse pregnancy outcome, the greatest exposure risks were fetal growth restriction (aOR 1.96, 95 % CI 1.91–2.01), antepartum hemorrhage (aOR 1.79, 95 % CI 1.73–1.85) and preterm birth (aOR 1.65, 95 % CI 1.62–1.68).

Conclusion

Patients with substance use disorder are at higher risk of adverse pregnancy outcomes, particularly fetal growth restriction, antepartum hemorrhage and preterm birth.

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CiteScore
2.20
自引率
0.00%
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31
审稿时长
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