Maternal opioid use disorder and infant mortality in Wisconsin, United States, 2010-2018.
Maternal opioid use disorder and infant mortality in Wisconsin, United States, 2010-2018.
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2010-2018 年美国威斯康星州孕产妇阿片类药物使用障碍和婴儿死亡率。
DOI：
10.1016/j.ypmed.2024.107914
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发表时间：
2024
影响因子：
5.1
通讯作者：
Ehrenthal,DeborahB
中科院分区：
文献类型：
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作者：
Mallinson,DavidC;Kuo,Hsiang-HuiDaphne;Kirby,RussellS;Wang,Yi;Berger,LawrenceM;Ehrenthal,DeborahB
母亲阿片类药物使用障碍（OUD）状态对婴儿健康结局的差异研究不足。我们测量了孕妇OUD在怀孕期间和婴儿死亡率之间的关联，并调查了这种关联是否不同的婴儿新生儿阿片类药物戒断综合征（NOWS）或母亲收到的药物OUD（MOUD）在pregnancy.MethodsWe抽样204，543医疗补助支付出生从威斯康星州，美国（2010-2018）。主要暴露是妊娠期间的任何母体OUD。我们还根据NOWS诊断（无OUD;无NOWS的OUD;有NOWS的OUD）和母亲接受MOUD（无OUD;无MOUD的OUD;连续MOUD <90天的OUD;连续MOUD超过90天的OUD）对这种暴露进行分层。我们的结果是婴儿死亡率（年龄<365天的死亡）。人口统计学调整后的Logistic回归与比值比（OR）和95%的置信区间（CI）的测量关联。ResultsMaternal OUD与婴儿死亡率的增加（OR 1.43; 95%CI 1.02-2.02）。在排除出生后5天内死亡的婴儿（即，在NOWS临床表现之前），婴儿死亡率的回归估计值与NOWS诊断无显著差异。同样，回归估计并没有显着不同的产妇MOUD接收在整个sample.ConclusionsMaternal OUD与婴儿死亡率的风险升高，没有证据表明修改NOWS，也没有产妇MOUD治疗。未来的研究应该调查潜在的机制，将母亲OUD，NOWS，MOUD治疗和婴儿死亡率联系起来，以更好地为临床干预提供信息。
ObjectiveThe difference in infant health outcomes by maternal opioid use disorder (OUD) status is understudied. We measured the association between maternal OUD during pregnancy and infant mortality and investigated whether this association differs by infant neonatal opioid withdrawal syndrome (NOWS) or maternal receipt of medication for OUD (MOUD) during pregnancy.MethodsWe sampled 204,543 Medicaid-paid births from Wisconsin, United States (2010–2018). The primary exposure was any maternal OUD during pregnancy. We also stratified this exposure on NOWS diagnosis (no OUD; OUD without NOWS; OUD with NOWS) and on maternal MOUD receipt (no OUD; OUD without MOUD; OUD with <90 consecutive days of MOUD; OUD with 90+ consecutive days of MOUD). Our outcome was infant mortality (death at age <365 days). Demographic-adjusted logistic regressions measured associations with odds ratios (OR) and 95% confidence intervals (CI).ResultsMaternal OUD was associated with increased odds of infant mortality (OR 1.43; 95% CI 1.02–2.02). After excluding infants who died <5 days post-birth (i.e., before the clinical presentation of NOWS), regression estimates of infant mortality did not significantly differ by NOWS diagnosis. Likewise, regression estimates did not significantly differ by maternal MOUD receipt in the full sample.ConclusionsMaternal OUD is associated with an elevated risk of infant mortality without evidence of modification by NOWS nor by maternal MOUD treatment. Future research should investigate potential mechanisms linking maternal OUD, NOWS, MOUD treatment, and infant mortality to better inform clinical intervention.