Opioid use disorder at delivery hospitalization in the United States: 2012-2016.
Opioid use disorder at delivery hospitalization in the United States: 2012-2016.
复制标题
美国分娩住院时阿片类药物使用障碍：2012-2016 年。
DOI：
10.1111/ajad.13417
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Arora,KavitaS
中科院分区：
文献类型：
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作者：
Malhotra,Tani;Sheyn,David;Arora,KavitaS
背景和目的本文的目的是评估患有和不患有阿片类药物使用障碍 (OUD) 的患者在分娩住院期间的全国趋势、社会经济风险因素以及孕产妇和产科结局。方法这是一个回顾性队列，使用 2012 年至 2016 年 3,554,477 例分娩的全国住院患者样本来分析分娩住院患者的 OUD 趋势。我们进行单变量和多变量 Logistic 回归来比较分娩住院期间 OUD 患者的临床、人口统计学、医院和地理关联。结果 分娩住院期间 OUD 发生率从 2012 年的每 1000 例分娩 4.48 例上升到 2016 年的 7.67 例。OUD 发生率最高的是东北地区，最低的是西部地区（每 1000 例分娩 9.29 例 vs. 4.13 例）。分别，p< .001)。调整混杂因素后，同时使用可卡因的历史（调整后的比值比 [aOR] = 5.95，95% 置信区间 [CI]：5.38–6.59）、镇静剂使用（aOR = 17.28，95% CI：14.71–20.31）和安非他明使用（aOR = 4.05，95% CI：3.71–4.43），与 OUD 密切相关。此外，丙型肝炎感染（aOR = 21.98，95% CI：20.89–23.11）、白种人（aOR = 3.12，95% CI：3.00–3.24）和公共保险（aOR = 3.92，95% CI：3.77–4.08）也与OUD。讨论和结论分娩住院中 OUD 发生率的持续增加及其与不良围产期结局的关联，凸显了对针对孕妇的计划进行普遍筛查和资源分配的必要性。科学意义我们的研究以报告 1998 年至 2011 年分娩住院中 OUD 趋势的先前文献为基础，并对危险因素和不良妊娠结局进行了比以前报道更深入的研究。
Background and ObjectivesThe objective of this paper is to evaluate national trends, socioeconomic risk factors, and maternal and obstetric outcomes for patients with and without opioid use disorder (OUD) at delivery hospitalization.MethodsThis is a retrospective cohort using the National Inpatient Sample 2012–2016 of 3,554,477 deliveries to analyze trends in OUD in patients at delivery hospitalization. We conducted univariable and multivariable logistic regression to compare clinical, demographic, hospital, and geographic associations for patients with OUD during delivery hospitalization.ResultsThe incidence of OUD at delivery hospitalization increased from 4.48 per 1000 deliveries in 2012 to 7.67 in 2016. The highest rate of OUD was in the Northeast and the lowest in the West (9.29 vs. 4.13 per 1000, respectively,p< .001). After adjusting for confounders, history of concurrent cocaine use (adjusted odds ratio [aOR] = 5.95, 95% confidence interval [CI]: 5.38–6.59), sedative use (aOR = 17.28, 95% CI: 14.71–20.31), and amphetamine use (aOR = 4.05, 95% CI: 3.71–4.43), were strongly associated with OUD. Additionally, hepatitis C infection, (aOR = 21.98, 95% CI: 20.89–23.11), white race (aOR = 3.12, 95% CI: 3.00–3.24), and public insurance (aOR = 3.92, 95% CI: 3.77–4.08) were also associated with OUD.Discussion and ConclusionThe continued increase in rates of OUD at delivery hospitalization and its association with adverse perinatal outcomes highlights the need for universal screening and resource allocation for programs directed toward pregnant people.Scientific SignificanceOur study builds upon the prior literature that reports trends in OUD at delivery hospitalization from 1998 to 2011 as well as presents a more in‐depth look at risk factors and adverse pregnancy outcomes than previously reported.