Racial and Ethnic Disparities in Maternal and Infant Outcomes Among Opioid-Exposed Mother Infant Dyads in Massachusetts (2017-2019)
Racial and Ethnic Disparities in Maternal and Infant Outcomes Among Opioid-Exposed Mother Infant Dyads in Massachusetts (2017-2019)
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DOI：
10.2105/ajph.2020.305888
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发表时间：
2020-12-01
影响因子：
12.7
通讯作者：
Schiff, Davida M.
中科院分区：
文献类型：
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作者：
Peeler, Mary;Gupta, Munish;Schiff, Davida M.
目标.研究妊娠期阿片类药物使用障碍（MOUD）和新生儿阿片类药物戒断综合征（NOWS）结局的差异与母亲种族/民族的相关程度。我们对2017年1月至2019年4月来自马萨诸塞州24家医院的阿片类药物暴露分娩的全州质量改进数据库进行了二次分析。我们采用多变量混合效应logistic回归模型分析母亲种族/民族（非西班牙裔白色、非西班牙裔黑人或西班牙裔）与产前接受MOUD、NOWS严重程度、早期干预转诊和出院时父母监护权之间的关系。在1710例阿片类药物使用障碍女性的分娩中，89.3%（n = 1527）为非西班牙裔白色人。在调整后的模型中，与非西班牙裔白色女性相比，非西班牙裔黑人女性（AOR = 0.34; 95%置信区间[CI] = 0.18，0.66）和西班牙裔女性（AOR = 0.43; 95% CI = 0.27，0.68）在妊娠期间接受MOUD的可能性较低。我们没有发现母亲种族/民族和婴儿结局之间有统计学意义的相关性。我们发现，在调整后的模型中，MOUD产前接收存在显着的种族/民族差异。研究应侧重于非西班牙裔黑人和西班牙裔妇女的观点和治疗经验，以确保对所有母婴的平等照顾。
Objectives. To examine the extent to which differences in medication for opioid use disorder (MOUD) in pregnancy and infant neonatal opioid withdrawal syndrome (NOWS) outcomes are associated with maternal race/ethnicity.Methods. We performed a secondary analysis of a statewide quality improvement database of opioid-exposed deliveries from January 2017 to April 2019 from 24 hospitals in Massachusetts. We used multivariable mixed-effects logistic regression to model the association between maternal race/ethnicity (non-Hispanic White, non-Hispanic Black, or Hispanic) and prenatal receipt of MOUD, NOWS severity, early intervention referral, and biological parental custody at discharge.Results. Among 1710 deliveries to women with opioid use disorder, 89.3% (n = 1527) were non-Hispanic White. In adjusted models, non-Hispanic Black women (AOR = 0.34; 95% confidence interval [CI] = 0.18, 0.66) and Hispanic women (AOR = 0.43; 95% CI = 0.27, 0.68) were less likely to receive MOUD during pregnancy compared with non-Hispanic White women. We found no statistically significant associations between maternal race/ethnicity and infant outcomes.Conclusions. We identified significant racial/ethnic differences in MOUD prenatal receipt that persisted in adjusted models. Research should focus on the perspectives and treatment experiences of non-Hispanic Black and Hispanic women to ensure equitable care for all motherinfant dyads.