美沙酮治疗项目中阿片类药物成瘾孕妇早产的危险因素。
Risk factors for preterm birth among opiate-addicted gravid women in a methadone treatment program.
作者信息
Almario Christopher V, Seligman Neil S, Dysart Kevin C, Berghella Vincenzo, Baxter Jason K
机构信息
Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
Am J Obstet Gynecol. 2009 Sep;201(3):326.e1-6. doi: 10.1016/j.ajog.2009.05.052. Epub 2009 Jul 24.
OBJECTIVE
Prior studies noted elevated preterm birth (PTB) rates among opiate-addicted women treated with methadone. We sought to determine the risk factors for PTB in this population.
STUDY DESIGN
We performed a retrospective cohort study of opiate-addicted gravid women treated with methadone who delivered a single neonate between 2000 and 2006. Variables evaluated as potential risk factors for PTB less than 37 weeks included medical and infectious comorbidities and "supplements to methadone" (illicit drugs and/or alcohol).
RESULTS
The overall PTB rate was 29.1% (75/258). No medical or infectious comorbidity was predictive of PTB. Among women abusing 0, 1, 2, or 3 or more supplements in addition to methadone, the PTB rate was 24.2% (reference), 25.5% (P = .50), 47.6% (P = .04), and 64.7% (P = .01), respectively.
CONCLUSION
The PTB rate among women on methadone (29.1%) is nearly 3 times the national average (11.1%), and those abusing 2 or more supplements to methadone are at further increased risk for PTB.
目的
先前的研究指出，接受美沙酮治疗的阿片类药物成瘾女性的早产（PTB）率有所升高。我们试图确定该人群中早产的危险因素。
研究设计
我们对2000年至2006年间接受美沙酮治疗且单胎分娩的阿片类药物成瘾孕妇进行了一项回顾性队列研究。评估为孕37周前早产潜在危险因素的变量包括内科及感染性合并症以及“美沙酮补充剂”（非法药物和/或酒精）。
结果
总体早产率为29.1%（75/258）。没有内科或感染性合并症可预测早产。在除美沙酮外滥用0种、1种、2种或3种及以上补充剂的女性中，早产率分别为24.2%（参照）、25.5%（P = 0.50）、47.6%（P = 0.04）和64.7%（P = 0.01）。
结论
接受美沙酮治疗的女性的早产率（29.1%）几乎是全国平均水平（11.1%）的3倍，且滥用2种或更多美沙酮补充剂的女性早产风险进一步增加。
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