Medication for Opioid Use Disorder During Pregnancy - Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021.
Medication for Opioid Use Disorder During Pregnancy - Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021.
复制标题
DOI：
10.15585/mmwr.ss7203a1
复制
发表时间：
2023-05-05
影响因子：
24.9
通讯作者：
Gilboa, Suzanne M
中科院分区：
文献类型：
--
作者：
Miele, Kathryn;Kim, Shin Y;Jones, Rachelle;Rembert, Juneka H;Wachman, Elisha M;Shrestha, Hira;Henninger, Michelle L;Kimes, Teresa M;Schneider, Patrick D;Sivaloganathan, Vaseekaran;Sward, Katherine A;Deshmukh, Vikrant G;Sanjuan, Pilar M;Maxwell, Jessie R;Seligman, Neil S;Caveglia, Sarah;Louis, Judette M;Wright, Tanner;Bennett, Carolyne Cody;Green, Caitlin;George, Nisha;Gosdin, Lucas;Tran, Emmy L;Meaney-Delman, Dana;Gilboa, Suzanne M
阿片类药物使用障碍（MOUD）的药物推荐用于妊娠期间阿片类药物使用障碍（OUD）的患者。然而，关于妊娠期间OUD管理的最佳实践存在知识差距，需要这些数据来指导临床护理。2014-2021.母婴网络了解妊娠期间阿片类药物使用障碍药物相关结果（MAT-LINK）成立于2019年，是美国七个临床站点的监测网络。波士顿医疗中心、Kaiser Permanente Northwest、俄亥俄州州立大学和犹他州大学是2019年的首批临床研究中心。2021年，该网络增加了三个临床站点（新墨西哥州大学、罗切斯特大学和南佛罗里达大学）。在七个临床中心接受护理的人员在地理、城市化、种族和民族、保险范围和接受的MOUD类型方面各不相同。MAT-LINK的目标是获取妊娠期间OUD患者的人口统计学和临床信息，以更好地了解MOUD对结局的影响，并最终为该人群的临床护理和公共卫生干预提供信息。MAT-LINK通过强大的信息技术架构保持严格的保密性。MAT-LINK监测方法、人群特征和评价结果在本就职监测报告中进行了描述。本报告是第一份描述该系统的报告，提供了关于供资、结构、数据要素和方法的详细信息，以及监督评价的结果。本报告中的研究结果仅限于总体孕妇和MOUD治疗状态的选定人口统计学特征。未纳入临床和结局数据，因为数据收集和清理尚未完成;临床和结局数据的初步分析将于2023年开始。MAT-LINK监测网络收集了2014-2021年期间来自7个临床研究中心的5，541例已知妊娠结局的OUD患者报告的妊娠数据。母亲的平均年龄为29.7（SD = ±5.1）岁。按种族和族裔划分，86.3%的孕妇为白色人，25.4%为西班牙裔或拉丁裔人，5.8%为黑人或非裔美国人。在孕妇中，81.6%有公共保险，84.4%居住在城市地区。与怀孕期间未接受MOUD的人相比，怀孕期间接受MOUD的人更有可能是老年人和白色人，并有公共保险。对监测系统的评估发现，最初的四个临床研究中心并不能代表美国南部或西南地区的人口统计数据，与美国总体人口相比，某些种族和族裔群体的代表性较低;然而，2021年增加的三个临床研究中心使监测网络更具代表性。自动提取和处理提高了数据收集和分析的速度。增加新的临床研究中心和变量的能力证明了MAT-LINK的灵活性。MAT-LINK是第一个从多个临床站点收集妊娠期间与MOUD相关的围产期结局的妊娠人-婴儿二元组的全面纵向数据的监测系统。临床试验机构数据分析表明，MOUD和非MOUD治疗组之间存在不同的社会人口统计学特征。MAT-LINK是一个及时、灵活的监测系统，拥有大约5 500例妊娠的数据。正在进行的数据收集和对这些数据的分析将提供信息，以支持临床和公共卫生指导，以改善OUD孕妇及其子女的健康结果。
Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care. 2014–2021. Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites in 2019. In 2021, three clinical sites were added to the network (the University of New Mexico, the University of Rochester, and the University of South Florida). Persons receiving care at the seven clinical sites are diverse in terms of geography, urbanicity, race and ethnicity, insurance coverage, and type of MOUD received. The goal of MAT-LINK is to capture demographic and clinical information about persons with OUD during pregnancy to better understand the effect of MOUD on outcomes and, ultimately, provide information for clinical care and public health interventions for this population. MAT-LINK maintains strict confidentiality through robust information technology architecture. MAT-LINK surveillance methods, population characteristics, and evaluation findings are described in this inaugural surveillance report. This report is the first to describe the system, presenting detailed information on funding, structure, data elements, and methods as well as findings from a surveillance evaluation. The findings presented in this report are limited to selected demographic characteristics of pregnant persons overall and by MOUD treatment status. Clinical and outcome data are not included because data collection and cleaning have not been completed; initial analyses of clinical and outcome data will begin in 2023. The MAT-LINK surveillance network gathered data on 5,541 reported pregnancies with a known pregnancy outcome during 2014–2021 among persons with OUD from seven clinical sites. The mean maternal age was 29.7 (SD = ±5.1) years. By race and ethnicity, 86.3% of pregnant persons were identified as White, 25.4% as Hispanic or Latino, and 5.8% as Black or African American. Among pregnant persons, 81.6% had public insurance, and 84.4% lived in urban areas. Compared with persons not receiving MOUD during pregnancy, those receiving MOUD during pregnancy were more likely to be older and White and to have public insurance. The evaluation of the surveillance system found that the initial four clinical sites were not representative of demographics of the South or Southwest regions of the United States and had low representation from certain racial and ethnic groups compared with the overall U.S. population; however, the addition of three clinical sites in 2021 made the surveillance network more representative. Automated extraction and processing improved the speed of data collection and analysis. The ability to add new clinical sites and variables demonstrated the flexibility of MAT-LINK. MAT-LINK is the first surveillance system to collect comprehensive, longitudinal data on pregnant person–infant dyads with perinatal outcomes associated with MOUD during pregnancy from multiple clinical sites. Analyses of clinical site data demonstrated different sociodemographic characteristics between the MOUD and non-MOUD treatment groups. MAT-LINK is a timely and flexible surveillance system with data on approximately 5,500 pregnancies. Ongoing data collection and analyses of these data will provide information to support clinical and public health guidance to improve health outcomes among pregnant persons with OUD and their children.