Marijuana, Opioid, and Alcohol Use Among Pregnant and Postpartum Individuals Living With HIV in the US.
Marijuana, Opioid, and Alcohol Use Among Pregnant and Postpartum Individuals Living With HIV in the US.
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DOI：
10.1001/jamanetworkopen.2021.37162
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发表时间：
2021-12-01
影响因子：
13.8
通讯作者：
Pediatric HIV/AIDS Cohort Study
中科院分区：
文献类型：
--
作者：
Yee LM;Kacanek D;Brightwell C;Haddad LB;Jao J;Powis KM;Yao TJ;Barr E;Broadwell C;Siminski S;Seage GR 3rd;Chadwick EG;Pediatric HIV/AIDS Cohort Study
这项队列研究评估了艾滋病毒感染者在怀孕期间和产后第一年自我报告的阿片类药物，酒精和大麻使用的流行趋势，并评估了大麻合法化状态与物质使用的关联。随着时间的推移，美国艾滋病毒感染者在怀孕期间和产后第一年使用大麻、酒精和阿片类药物的趋势是什么？在这项队列研究中，包括来自抗逆转录病毒毒性监测（SMARTT）研究的2310名怀孕和产后艾滋病毒感染者，大麻的使用从2007年到2019年有所增加，并且在医用大麻合法化的地方更频繁。酒精和阿片类药物使用的流行率在此期间没有变化。这些发现表明，怀孕的艾滋病毒感染者使用大麻的情况越来越多，这表明有必要进一步关注临床和研究，因为这对怀孕和艾滋病毒相关的健康有潜在的影响。在阿片类药物的流行以及大麻的法律的和社会变化中，人们对怀孕和产后艾滋病毒感染者的药物使用知之甚少。评估美国艾滋病毒感染者在怀孕期间和产后第一年使用大麻，酒精和阿片类药物的趋势以及基于大麻合法化状态的药物使用差异。分析了儿科HIV/AIDS队列研究中抗逆转录病毒毒性监测（SMARTT）研究的数据。对2007年1月1日至2019年7月1日期间在美国22个研究中心登记的SMARTT妊娠艾滋病毒感染者进行了评估，并对妊娠期、产后1年或两者的自我报告药物使用数据进行了评估。日历年和国家大麻合法化的地位。按日历年计算使用以下每种物质的流行率，分别用于怀孕和产后：大麻，酒精，阿片类药物以及伴随的酒精和大麻。使用一般估计方程拟合对数二项式模型，以评估平均年变化，考虑重复妊娠。该研究还评估了州娱乐或医用大麻合法化状态在物质使用方面的差异。2310名艾滋病毒感染者中有2926名孕妇的药物使用数据（平均[SD]年龄，28.8 [6.1]岁;西班牙裔822人[28.1%]，非西班牙裔黑人1859人[63.5%]，白色185人[6.3%]，24人[0.8%]属于1个以上种族，24例[0.8%]其他人种或种族[确定为美洲印第安人、亚洲人或夏威夷原住民或其他太平洋岛民的个体]，12例[0.4%]未知或未报告人种或种族）。在2007年至2019年期间，怀孕期间使用大麻的比例从7.1%增加到11.7%，而怀孕期间使用酒精和阿片类药物的比例没有变化。产后酒精（44.4%），大麻（13.6%）以及伴随酒精和大麻（10.0%）的使用很常见;从2007年到2019年，大麻的使用从10.2%增加到23.7%，而产后酒精的使用没有变化。在怀孕期间，大麻使用的调整平均风险每年增加7%（95%CI，3%-10%），产后每年增加11%（95%CI，7%-16%）。产后伴随酒精和大麻的使用每年增加10%（95% CI，5%-15%）。物质使用的差异与娱乐合法化无关，但大麻使用的增加与医用大麻合法化有关。在这项队列研究中，感染艾滋病毒的孕妇使用阿片类药物保持稳定，而怀孕期间和产后使用大麻随着时间的推移和医用大麻合法化的州而增加。这些怀孕和产后感染艾滋病毒的人使用大麻的模式表明，鉴于物质使用对孕产妇和儿童健康的潜在影响，加强临床关注是必要的。
This cohort study evaluates trends over time in the prevalence of self-reported opioid, alcohol, and marijuana use during pregnancy and in the first year postpartum among people living with HIV and assesses the association of marijuana legalization status with substance use. What are the trends over time in marijuana, alcohol, and opioid use during pregnancy and the first year postpartum among US persons living with HIV? In this cohort study including 2310 pregnant and postpartum individuals living with HIV from the Surveillance Monitoring for Antiretroviral Toxicities (SMARTT) study, use of marijuana increased from 2007 to 2019 and was more frequent in locations with medical marijuana legalization. Prevalence of alcohol and opioid use did not change over that time. These findings of increasing marijuana use among pregnant people living with HIV suggest that further clinical and research attention is warranted, given the potential implications for pregnancy and HIV-related health. Amid the opioid epidemic and evolving legal and social changes with marijuana, little is known about substance use among pregnant and postpartum people living with HIV. To evaluate trends in marijuana, alcohol, and opioid use during pregnancy and the first year postpartum among US people living with HIV and the differences in substance use based on marijuana legalization status. Data from the Surveillance Monitoring for Antiretroviral Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study were analyzed. SMARTT-enrolled, pregnant people living with HIV at 22 US sites from January 1, 2007, to July 1, 2019, with self-reported substance use data available in pregnancy, 1 year postpartum, or both were assessed. Calendar year and state marijuana legalization status. The prevalence of any use of each of the following substances was calculated by calendar year, separately for pregnancy and postpartum: marijuana, alcohol, opioid, and concomitant alcohol and marijuana. Log binomial models were fit using general estimating equations to evaluate the mean annual change, accounting for repeat pregnancies. The study also evaluated differences in substance use by state recreational or medical marijuana legalization status. Substance use data were available for 2926 pregnancies from 2310 people living with HIV (mean [SD] age, 28.8 [6.1] years; 822 [28.1%] Hispanic, 1859 [63.5%] non-Hispanic Black, 185 [6.3%] White, 24 [0.8%] of more than 1 race, 24 [0.8%] of other race or ethnicity [individuals who identified as American Indian, Asian, or Native Hawaiian or other Pacific Islander], and 12 [0.4%] with unknown or unreported race or ethnicity). Between 2007 and 2019, marijuana use during pregnancy increased from 7.1% to 11.7%, whereas alcohol and opioid use in pregnancy were unchanged. Postpartum alcohol (44.4%), marijuana (13.6%), and concomitant alcohol and marijuana (10.0%) use were common; marijuana use increased from 10.2% to 23.7% from 2007 to 2019, whereas postpartum alcohol use was unchanged. The adjusted mean risk of marijuana use increased by 7% (95% CI, 3%-10%) per year during pregnancy and 11% (95% CI, 7%-16%) per year postpartum. Postpartum concomitant alcohol and marijuana use increased by 10% (95% CI, 5%-15%) per year. Differences in substance use were not associated with recreational legalization, but increased marijuana use was associated with medical marijuana legalization. In this cohort study, opioid use among pregnant people living with HIV remained stable, whereas marijuana use during pregnancy and postpartum increased over time and in states with legalized medical marijuana. These patterns of increasing marijuana use among pregnant and postpartum people living with HIV suggest that enhanced clinical attention is warranted, given the potential maternal and child health implications of substance use.
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影响因子：
33.9
作者：
England, Lucinda J.;Bennett, Carolyne;Boyle, Coleen A.
通讯作者：
Boyle, Coleen A.
DOI：
10.1080/14767058.2020.1765157
发表时间：
2020-05-14
影响因子：
1.8
作者：
Lee, Emily;Pluym, Ilina D.;Rao, Rashmi
通讯作者：
Rao, Rashmi
DOI：
10.1080/14767058.2016.1269165
发表时间：
2017-12
期刊：
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
影响因子：
--
作者：
Dotters-Katz SK;Smid MC;Manuck TA;Metz TD
通讯作者：
Metz TD
影响因子：
9.8
作者：
Badreldin N;Grobman WA;Chang KT;Yee LM
通讯作者：
Yee LM
影响因子：
9.8
作者：
Badreldin, Nevert;Grobman, William A.;Yee, Lynn M.
通讯作者：
Yee, Lynn M.