Pregnancy-associated mortality and morbidity due to drug use, self-harm, and violence: changes during the COVID-19 pandemic

由于吸毒、自残和暴力而导致的与妊娠相关的死亡率和发病率：COVID-19 大流行期间的变化

• 批准号: 10665190
• 负责人: Sidra Goldman-Mellor
• 金额: $ 15.88万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665190
• 关键词: Accident and Emergency department; Administrative Supplement; American; Area; Birth Records; COVID-19 pandemic; COVID-19 pandemic effects; California; Cause of Death; Cessation of life; Clinical; Data; Data Set; Databases; Death Certificates; Death Records; Discipline of obstetrics; Domestic Violence; Drug Utilization; Drug usage; Emergency Department patient; Emergency department visit; Ethnic Origin; Funding; Goals; Health Professional; High Risk Woman; Homicide; Hospital Departments; Hospitalization; Hospitals; Incidence; Individual; Infection; Inpatients; Insurance Coverage; Link; Mental Health; Morbidity - disease rate; National Institute of Child Health and Human Development; Outcome; Overdose; Parents; Patient Discharge; Pattern; Persons; Pharmaceutical Preparations; Population; Postpartum Period; Pregnancy; Prevention; Preventive care; Public Health; Race; Reporting; Research; Self-Injurious Behavior; Social isolation; Suicide; System; United States; Victimization; Violence; Vital Statistics; Vulnerable Populations; health care availability; mortality; mortality disparity; mortality statistics; pandemic disease; people of color; population based; pregnancy associated death; pregnant; rurality; screening; substance use; suicide rate; trend

PROJECT SUMMARY The goal of our Parent R01 (R01HD102319, “Pregnancy-associated mortality and morbidity due to drugs, self- harm, and violence in the United States”) is to provide population-based estimates of incidence, trends, and disparities in mortality and morbidity during pregnancy and the first year postpartum due to drug use, self- harm, and violence, and to ascertain which factors can identify women at high risk of these outcomes in hospital and emergency department (ED) settings. We recently reported that pregnancy-associated mortality due to drugs, self-harm, and suicide made up 22.2% of all deaths during pregnancy and postpartum from 2010-2019 in the US. Pregnancy-associated deaths from these causes also increased substantially over the past decade, with drug-related deaths, in particular, increasing 190% from 2010 to 2019. We also know that the COVID-19 pandemic resulted in worsened mental health, increased social isolation, reduced utilization of preventive care, and increased financial instability and that, in the general US population, drug-related deaths and homicides increased approximately 30% during the first year of the pandemic. The overall goal of this Administrative Supplement, “Pregnancy-associated mortality and morbidity due to drug use, self-harm, and violence: changes during the COVID-19 pandemic” is thus to investigate the impacts of the COVID-19 pandemic on morbidity and mortality due to drugs, self-harm, and violence among pregnant and postpartum individuals, an especially vulnerable group. Our first aim is to examine incidence, trends, and disparities in pregnancy-associated mortality due to drugs, suicide, and homicide in the US in 2020 and 2021, and compare these estimates to the trends we observed from 2010-2019. Our second aim is to examine incidence, trends, and disparities in pregnancy-associated morbidity (i.e., emergency department utilization) due to drugs, deliberate self-harm, and violence in California in 2020 and 2021, coinciding with the onset of the COVID-19 pandemic in March 2020, and compare these estimates to pre-pandemic patterns. To achieve these aims, we will use both US vital statistics mortality and natality data as well as a unique set of linked California databases that include inpatient hospitalizations and emergency department visits. Achieving these aims will provide evidence for clinicians and public health professionals regarding the current burden of pregnancy-associated morbidity and mortality due to drug use, self-harm, and violent victimization in the context of the COVID-19 pandemic. Such evidence can be used to guide public health and clinical planning as well as future research efforts in areas such as screening, prevention, and treatment.

项目概要 我们家长 R01 的目标（R01HD102319，“由于药物、自身原因导致的妊娠相关死亡率和发病率”） 美国的伤害和暴力”）的目的是提供基于人口的发生率、趋势和暴力的估计 妊娠期间和产后第一年由于吸毒、自我保健等原因造成的死亡率和发病率存在差异 伤害和暴力，并确定哪些因素可以识别出在这些结果中处于高风险的妇女 医院和急诊室 (ED) 设置。我们最近报道了与妊娠相关的死亡率 因药物、自残和自杀而导致的妊娠期和产后死亡人数占 22.2% 2010-2019 年在美国。这些原因导致的与妊娠相关的死亡也大幅增加 过去十年，特别是与毒品相关的死亡人数，从 2010 年到 2019 年增加了 190%。我们还知道 COVID-19 大流行导致心理健康状况恶化、社会孤立加剧、资源利用减少 预防保健、金融不稳定加剧以及美国普通民众中与毒品相关的死亡 在大流行的第一年，凶杀案增加了约 30%。本次活动的总体目标 行政补充，“由于吸毒、自残和行为导致的妊娠相关死亡率和发病率” 因此，“暴力：COVID-19 大流行期间的变化”旨在调查 COVID-19 的影响 孕妇和产后因毒品、自残和暴力造成的发病率和死亡率大流行 个人，尤其是弱势群体。我们的首要目标是检查发病率、趋势和差异 2020 年和 2021 年美国因毒品、自杀和他杀而导致的妊娠相关死亡率，并进行比较 这些估计是我们对 2010-2019 年观察到的趋势的估计。我们的第二个目标是检查发病率、趋势、 以及由于药物导致的妊娠相关发病率（即急诊科利用率）的差异， 2020 年和 2021 年加利福尼亚州发生故意自残和暴力事件，恰逢新冠肺炎 (COVID-19) 疫情爆发 2020 年 3 月的大流行，并将这些估计值与大流行前的模式进行比较。为了实现这些目标，我们 将使用美国生命统计死亡率和出生率数据以及一组独特的加州链接数据库 其中包括住院治疗和急诊科就诊。实现这些目标将提供 为临床医生和公共卫生专业人员提供有关当前妊娠相关负担的证据 COVID-19 背景下因吸毒、自残和暴力受害而导致的发病率和死亡率 大流行。此类证据可用于指导公共卫生和临床规划以及未来的研究 并在筛查、预防和治疗等方面做出努力。