Racial Misclassification and Disparities in Neonatal Abstinence Syndrome Among American Indians and Alaska Natives.
Racial Misclassification and Disparities in Neonatal Abstinence Syndrome Among American Indians and Alaska Natives.
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DOI：
10.1007/s40615-021-01127-z
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发表时间：
2022-10
影响因子：
3.9
通讯作者：
Lapidus J
中科院分区：
文献类型：
--
作者：
Lan CW;Joshi S;Dankovchik J;Jimenez C;Needham Waddell E;Lutz T;Lapidus J
母体滥用药物可导致新生儿戒断综合征 (NAS)，这是一种在子宫内接触药物的新生儿的戒断过程。本研究旨在探讨太平洋西北地区两个出院数据集中美洲印第安人和阿拉斯加原住民 (AI/AN) 的种族错误分类对 NAS 率的影响。我们在西北部落登记处与俄勒冈州和华盛顿州的医院出院数据集之间进行了概率记录关联，以纠正 AI/AN 人的种族错误分类。我们使用国际疾病分类第九版/第十版临床修订版（ICD-9-CM 或 ICD-10-CM）诊断代码评估结果。连接使俄勒冈州 AI/AN 中 NAS 病例的确定率提高了 8.8%，华盛顿州提高了 18.1%。在俄勒冈州和华盛顿州，AI/AN 新生儿被诊断出 NAS 的可能性分别是 NHW 新生儿的 1.5 倍和 3.9 倍。结果显示，居住在华盛顿农村地区的新生儿被诊断出患有 NAS 的可能性是居住在城市地区的新生儿的 1.4 倍。正确的种族分类是提高 AI/AN 人群数据质量和建立准确监测的重要因素，有助于解决 AI/AN 中新生儿戒断综合症的不成比例的负担。结果强调，需要根据保险状况和农村地区情况，针对使用药物的孕妇制定规划。
Maternal substance misuse can result in neonatal abstinence syndrome (NAS), a drug withdrawal process in newborns exposed in utero to drugs. This study aimed to examine the effect of racial misclassification of American Indians and Alaska Natives (AI/AN) on rates of NAS in two hospital discharge datasets in the Pacific Northwest. We conducted probabilistic record linkages between the Northwest Tribal Registry and Oregon and Washington hospital discharge datasets to correct racial misclassification of AI/AN people. We assessed outcomes using International Classification of Disease, Ninth Revision/Tenth Revision, Clinical Modification (ICD-9-CM or ICD-10-CM) diagnosis codes. Linkage increased ascertainment of NAS cases among AI/AN by 8.8% in Oregon, and by 18.1% in Washington. AI/AN newborns were 1.5 and 3.9 times more likely to be diagnosed with NAS than NHW newborns in Oregon and Washington, respectively. The results showed that newborns residing in rural Washington were 1.4 times more likely to be diagnosed with NAS than those living in urban areas. Correct racial classification is an important factor in improving data quality for AI/AN populations and establishing accurate surveillance to help address the disproportionate burden of neonatal abstinence syndrome among AI/AN. The results highlight the need for programing efforts tailored by insurance status and rurality for pregnant women using substances.
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