Prenatal Opioid Exposure: Birth, health, socioeconomic, and educational outcomes of mothers and their children

产前阿片类药物暴露：母亲及其子女的出生、健康、社会经济和教育结果

• 批准号: 10158505
• 负责人: Lawrence M Berger
• 金额: $ 44.01万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-04 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10158505
• 关键词: Address; Affect; Age; Alcohols; Automobile Driving; Behavior Therapy; Big Data; Biological; Birth; Birth Records; Caring; Characteristics; Child; Child Abuse and Neglect; Child Development; Child Welfare; Childbirth; Clinical; Communities; Complement; Complex; Criminal Justice; Data; Demography; Diagnosis; Education; Employment; Epidemic; Exposure to; Family; Fertility; General Population; Health; Healthcare; Individual; Infant; Knowledge; Life; Link; Live Birth; Low Birth Weight Infant; Maternal and Child Health; Medicaid; Minority; Mothers; Multiple Partners; Neonatal Abstinence Syndrome; Newborn Infant; Opioid; Outcome; Pathway interactions; Phase; Policies; Population; Positioning Attribute; Postpartum Period; Pregnancy; Pregnant Women; Prevalence; Public Policy; Quasi-experiment; Reporting; Reproductive Health; Research; Research Support; Resources; Savings; Shapes; Siblings; Social Environment; Social Welfare; Social Work; Source; Time; Tobacco; United States National Institutes of Health; Update; Vulnerable Populations; Wisconsin; Woman; addiction; base; behavioral outcome; child protective service; cohort; combat; economic outcome; fetal; fetal opioid exposure; fetal substance exposure; foster care; healthcare community; improved outcome; maternal cocaine use; maternal opioid use; medication-assisted treatment; opioid epidemic; opioid exposure; opioid use; opioid use disorder; prenatal; prenatal exposure; prescription opioid; service programs; social; socioeconomics; treatment strategy; trend

Project Summary/Abstract The rapid rise in prenatal exposure to prescription and other opioids over the last decade mirrors dramatic trends in opioid use across the general population of the US. In some states nearly one in four pregnancies are exposed to prescription opioids; 60-80% of affected pregnancies are Medicaid-covered. Moreover, the rise in maternal opioid use disorder (OUD), prenatal opioid exposure, and neonatal abstinence syndrome (NAS) appears to be driving a substantial increase child protective services (CPS) involvement. However, the impact of prenatal opioid exposure on pregnancy and child outcomes, independent of co-occurring factors, remains unclear. To address this gap, we have assembled a multi-source longitudinal administrative birth cohort that links data for all ~800,000 live births across Wisconsin, including ~350,000 Medicaid-covered births, from 2007 to 2018. By linking data at the individual-level, and updating each source of data annually, we can identify and track subsequent births (siblings) and follow a growing cohort of mothers and their children as their lives unfold over more than a decade. Our unique data support multilevel examination of individual factors, and the influence of health care and community characteristics, that is needed to better understand and address the effects of the opioid epidemic on women and their children. We will use regression-based and quasi-experimental methods, and geospatially informed analyses, to examine outcomes and factors which may influence outcomes. Our specific aims are: 1) Estimate the bounded annual prevalence of prenatal opioid exposure, including OUD and infant NAS, among all Medicaid-covered births in Wisconsin from 2007-2018, and describe the characteristics of affected women, families, and their communities, and changes therein over time; 2) Examine associations of prenatal opioid exposure, including OUD and NAS, with behaviors and outcomes including a) adverse pregnancy and birth outcomes; b) child maltreatment reports, substantiated reports, and foster care entries; and c) reproductive, health, social, educational, and economic outcomes for mothers and children, spanning the prenatal period through the first 8 years of the child’s life; 3) Investigate individual and community-level factors associated with maternal participation in addiction treatment during the prenatal and postpartum periods, including type(s) of treatment and treatment retention; and 4) Estimate plausibly causal effects of addiction treatment participation on maternal and child wellbeing spanning the child’s birth through age 8 using a quasi-experimental design. This research addresses the HHS 5-Point Strategy to Combat the Opioid Crisis, with a call for Better Data and Better Research, and complements the research into the biological pathways and treatment strategies enabled by the Trans NIH effort Helping to End Addiction Long-termSM (HEAL) Initiative.

项目摘要/摘要 过去十年来，产前暴露于处方和其他阿片类药物的迅速上升反映了戏剧性的趋势 在美国一般人群中使用阿片类药物。在某些州，几乎四分之一的怀孕暴露 处方阿片类药物； 60-80％的受影响的妊娠进行了医疗补助。而且，母性的上升 Opioid使用障碍（OUD），产前卵毒素暴露和新生儿戒毒综合征（NAS）似乎是 推动大幅增加儿童保护服务（CPS）的参与。但是，产前阿片类药物的影响 与同时发生的因素无关的怀孕和儿童结局的暴露尚不清楚。解决 这个差距，我们组装了一个多源纵向行政出生队列，该纵向链接了所有〜800,000 从2007年到2018 个人级别，并每年更新每个数据源，我们可以识别和跟踪后续出生 （兄弟姐妹）并跟随越来越多的母亲及其子女，因为他们的生活发展了十多年。 我们独特的数据支持对个人因素的多层次检查，以及医疗保健的影响和 社区特征，需要更好地理解和解决Ooid流行的影响 关于妇女及其子女。我们将使用基于回归的和准实验方法，以及地理空间 知情分析，以检查可能影响结果的结果和因素。我们的具体目的是：1） 估计产前阿片类药物暴露的年度患病率，包括OUD和婴儿NAS 2007 - 2018年威斯康星州的医疗补助覆盖的出生，描述受影响妇女的特征， 随着时间的流逝，家庭及其社区以及其中的变化； 2）检查产前阿片类药物的关联 曝光，包括OUD和NAS，具有行为和结果，包括a）不良怀孕和出生 结果； b）儿童虐待报告，实质性报告和寄养条目； c）生殖， 母亲和儿童的健康，社会，教育和经济成果，跨越产前 在孩子生命的前8年中； 3）调查与个人和社区级别的因素 在产前和产后期间，孕产妇参与其他治疗，包括 治疗和治疗保留率； 4）估计成瘾治疗参与的可能因果关系 关于跨越孩子的孕产妇和儿童健康，使用准实验设计跨越了8岁。这 研究涉及与阿片类药物危机作斗争的HHS 5点策略，并呼吁寻求更好的数据和 更好的研究，并完成对生物学途径和治疗策略的研究 通过Trans NIH的努力，有助于结束成瘾的长期（Heal）倡议。