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

项目总结 我们的父母R01(R01HD102319)的目标是“因药物导致的妊娠相关死亡率和发病率，自我 美国的伤害和暴力“)是提供基于人口的发病率、趋势和 怀孕期间和产后第一年因药物使用而导致的死亡率和发病率的差异 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(ED)设置。我们最近报告称，与怀孕相关的死亡率 由于吸毒、自残和自杀，占所有怀孕和产后死亡的22.2%。 2010-2019年在美国。这些原因导致的与怀孕有关的死亡人数也在过去几年大幅增加 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， 新冠肺炎大流行导致心理健康恶化，增加了社会孤立，减少了对 预防性护理，金融不稳定增加，以及在美国一般人口中，与毒品有关的死亡 在大流行的第一年，杀人案增加了大约30%。这个项目的总体目标是 行政补编，“与怀孕有关的死亡率和因药物使用、自我伤害和 因此，《新冠肺炎大流行期间的变化：暴力》就是为了调查新冠肺炎的影响 孕妇和产后因药物、自残和暴力造成的发病率和死亡率大流行 个人，一个特别脆弱的群体。我们的第一个目标是检查发病率、趋势和差距 2020年和2021年美国因毒品、自杀和凶杀而导致的妊娠相关死亡率，并进行了比较 这些估计与我们从2010-2019年观察到的趋势相一致。我们的第二个目标是研究发病率、趋势、 以及因药物导致的妊娠相关发病率(即急诊科的使用)的差异， 故意自残，加州2020年和2021年的暴力事件，恰逢新冠肺炎的开始 并将这些估计数与大流行前的模式进行比较。为了达到这些目标，我们 将使用美国生命统计数据、死亡率和出生数据，以及一套独特的加州链接数据库 这包括住院治疗和急诊科就诊。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与怀孕相关的负担的证据 新冠肺炎背景下的吸毒、自残和暴力受害致残率和死亡率 大流行。这些证据可以用来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.