Association Between Prenatal Opioid Exposure and Neurodevelopmental Outcomes in Early Childhood: A Retrospective Cohort Study.
Association Between Prenatal Opioid Exposure and Neurodevelopmental Outcomes in Early Childhood: A Retrospective Cohort Study.
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DOI：
10.1007/s40264-021-01080-0
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发表时间：
2021-08
期刊：
影响因子：
4.2
通讯作者：
Meador KJ
中科院分区：
文献类型：
--
作者：
Wen X;Lawal OD;Belviso N;Matson KL;Wang S;Quilliam BJ;Meador KJ
一些研究报告称，孕妇使用处方类阿片的流行率日益上升。然而，关于母体使用阿片类药物对没有阿片类药物使用障碍或药物依赖证据的孕妇幼儿期神经发育障碍的影响，人们知之甚少。本研究的目的是量化母体处方使用的产前阿片类药物暴露与儿童早期神经发育结果之间的关联。这项回顾性研究包括Optum的去识别Clinformatics® Data Mart数据库中12-55岁的孕妇及其2010年至2012年出生的活产婴儿。对无阿片类药物使用障碍或药物依赖的母亲所生的合格婴儿进行随访，直至发生神经发育障碍、失访或研究结束（2017年12月31日），以先发生者为准。精细分层的倾向评分用于调整人口统计学特征、产科特征、母体共病精神和疼痛状况以及疾病负担指标的混杂因素，并获得调整后的风险比（HR）和95%置信区间（CI）。比较了暴露和未暴露的婴儿神经发育障碍的发生率。在24，910名新生儿中，7.6%（1899名）在产前暴露于处方阿片类药物。总体而言，1562名儿童被诊断为神经发育障碍，暴露儿童的粗发病率为2.9/100人-年，而未暴露儿童的粗发病率为2.5/100人-年。校正后，我们观察到胎儿阿片类药物暴露与神经发育障碍风险之间无相关性（HR 1.10; 95% CI 0.92-1.32）。然而，在累积暴露持续时间较长（HR 1.70; 95% CI 1.05-2.96）或阿片类药物累积剂量较高（HR 1.22; 95% CI 1.01-1.54）的儿童中观察到神经发育障碍风险增加。在没有阿片类药物使用障碍或药物依赖的孕妇中，母体阿片类药物使用与儿童早期神经发育障碍风险增加无关。然而，在妊娠期间接受处方阿片类药物较长时间和较高剂量的妇女所生的儿童中观察到早期神经发育障碍的风险增加。
Several studies have reported increasing prevalence of prescription opioid use among pregnant women. However, little is known regarding the effects of maternal opioid use on neurodevelopmental disorders in early childhood in pregnant women with no evidence of opioid use disorders or drug dependence. The aim of this study was to quantify the association between prenatal opioid exposure from maternal prescription use and neurodevelopmental outcomes in early childhood. This retrospective study included pregnant women aged 12–55 years and their live-birth infants born from 2010 to 2012 present in Optum’s deidentified Clinformatics® Data Mart database. Eligible infants born to mothers without opioid use disorders or drug dependence were followed till occurrence of neurodevelopmental disorders, loss to follow-up, or study end (December 31, 2017), whichever came first. Propensity score by fine stratification was applied to adjust for confounding by demographic characteristics, obstetric characteristics, maternal comorbid mental and pain conditions, and measures of burden of illnesses and to obtain adjusted hazard ratios (HR) and 95% confidence intervals (CI). Exposed and unexposed infants were compared on the incidence of neurodevelopmental disorders. Of 24,910 newborns, 7.6% (1899) were prenatally exposed to prescription opioids. Overall, 1562 children were diagnosed with neurodevelopmental disorders, with crude incidence rates of 2.9 per 100 person-years in exposed children versus 2.5 per 100 person-years in unexposed children. After adjustment, we observed no association between fetal opioid exposure and the risk of neurodevelopmental disorders (HR 1.10; 95% CI 0.92–1.32). However, increased risk of neurodevelopmental disorders were observed in children with longer cumulative exposure duration (HR 1.70; 95% CI 1.05–2.96) or high cumulative opioid doses (HR 1.22; 95% CI 1.01–1.54). In pregnant women without opioid use disorders or drug dependence, maternal opioid use was not associated with increased risk of neurodevelopmental disorders in early childhood. However, increased risks of early neurodevelopmental disorders were observed in children born to women receiving prescription opioids for longer duration and at higher doses during pregnancy.
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影响因子：
5.6
作者：
Epstein, Richard A.;Bobo, William V.;Martin, Peter R.;Morrow, James A.;Wang, Wei;Chandrasekhar, Rameela;Cooper, William O.
通讯作者：
Cooper, William O.
影响因子：
9.8
作者：
Broussard, Cheryl S.;Rasmussen, Sonja A.;Honein, Margaret A.
通讯作者：
Honein, Margaret A.
CDC规定慢性疼痛的阿片类药物的指南 - 美国，2016年。
DOI：
10.1001/jama.2016.1464
发表时间：
2016-04-19
期刊：
JAMA
影响因子：
--
作者：
Dowell D;Haegerich TM;Chou R
通讯作者：
Chou R
影响因子：
1.1
作者：
Golalipour MJ;Ghafari S
通讯作者：
Ghafari S
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.