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

项目摘要 我们的母研究R 01（R 01 HD 102319，“妊娠相关的死亡率和发病率由于药物，自我- 伤害，和暴力在美国”）是提供基于人口的估计发病率，趋势， 怀孕期间和产后第一年因吸毒、自我保健和 伤害和暴力，并确定哪些因素可以确定妇女在这些结果的高风险， 医院和急诊科（艾德）设置。我们最近报道了妊娠相关死亡率 由于药物，自我伤害和自杀占怀孕期间和产后死亡的22.2%， 2010-2019在美国这些原因造成的与怀孕有关的死亡在2000年也大幅增加。 在过去十年中，与毒品有关的死亡人数从2010年到2019年增加了190%。我们也知道 COVID-19大流行导致心理健康恶化，社会孤立增加， 预防保健，增加金融不稳定，在一般美国人口中，与毒品有关的死亡 在大流行的第一年，凶杀案增加了大约30%。这个项目的总体目标是 行政补充文件，“由于吸毒、自残和其他原因造成的与怀孕有关的死亡率和发病率， 暴力：COVID-19大流行期间的变化”因此旨在调查COVID-19的影响 关于孕妇和产后妇女因毒品、自残和暴力而发病和死亡的流行病 个人，一个特别弱势的群体。我们的第一个目标是检查发病率，趋势和差异， 2020年和2021年美国因毒品、自杀和凶杀导致的妊娠相关死亡率，并比较 这些估计与我们从2010-2019年观察到的趋势有关。我们的第二个目标是检查发病率，趋势， 以及妊娠相关发病率的差异（即，急诊科使用）， 2020年和2021年加州发生的故意自残和暴力事件，恰逢COVID-19的爆发 2020年3月的大流行，并将这些估计与大流行前的模式进行比较。为了实现这些目标，我们 将使用美国的生命统计死亡率和出生率数据以及一套独特的链接加州数据库 包括住院治疗和急诊。实现这些目标将提供 临床医生和公共卫生专业人员关于目前妊娠相关疾病负担的证据 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 流行病这些证据可用于指导公共卫生和临床规划以及未来的研究 在筛查、预防和治疗等领域的努力。

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.