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孕期使用甲基苯丙胺所致并发症的结局。

Outcomes in pregnancies complicated by methamphetamine use.

作者信息

Gorman Margaret C, Orme Kaebah S, Nguyen Nancy T, Kent Edward J, Caughey Aaron B

机构信息

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR.

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR.

出版信息

Am J Obstet Gynecol. 2014 Oct;211(4):429.e1-7. doi: 10.1016/j.ajog.2014.06.005. Epub 2014 Jun 4.

Abstract

OBJECTIVE

Methamphetamine use is widespread. Our goal was to examine the effects of methamphetamine use on various maternal and neonatal outcomes.

STUDY DESIGN

We conducted a retrospective cohort study looking at all pregnancies between 2005 and 2008 in the state of California that were associated with a diagnosis of methamphetamine use. Outcomes examined included gestational hypertension, preeclampsia, preterm birth, small for gestational age, birthweight, abruption, intrauterine fetal death, neonatal death, infant death, jaundice, and gestational diabetes mellitus. Statistical analysis included chi-squared tests and multivariable logistic regression analyses.

RESULTS

After adjustment for multiple confounding variables on multivariable regression analysis, results indicated that compared with control subjects, methamphetamine users had greater odds of gestational hypertension (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.6-2.0), preeclampsia (OR, 2.7; 95% CI, 2.4-3.0), intrauterine fetal death (OR, 5.1; 95% CI, 3.7-7.2), and abruption (OR, 5.5; 95% CI, 4.9-6.3). Additionally, these patients had higher odds of preterm birth (OR, 2.9; 95% CI, 2.7-3.1), neonatal death (OR, 3.1; 95% CI, 2.3-4.2), and infant death (OR, 2.5; 95% CI, 1.7-3.7).

CONCLUSION

Methamphetamine use in pregnancy was found to be associated with specific patterns of increased maternal and fetal morbidity and death. With these results in mind, further work can be done to improve the care of pregnancies that are complicated by methamphetamine use in hopes of reducing these complications.

摘要

目的

甲基苯丙胺的使用很普遍。我们的目标是研究使用甲基苯丙胺对各种孕产妇和新生儿结局的影响。

研究设计

我们进行了一项回顾性队列研究,观察2005年至2008年加利福尼亚州所有与甲基苯丙胺使用诊断相关的妊娠情况。所检查的结局包括妊娠期高血压、先兆子痫、早产、小于胎龄儿、出生体重、胎盘早剥、宫内胎儿死亡、新生儿死亡、婴儿死亡、黄疸和妊娠期糖尿病。统计分析包括卡方检验和多变量逻辑回归分析。

结果

在多变量回归分析中对多个混杂变量进行调整后,结果表明,与对照组相比,使用甲基苯丙胺的人发生妊娠期高血压(优势比[OR],1.8;95%置信区间[CI],1.6 - 2.0)、先兆子痫(OR,2.7;95% CI,2.4 - 3.0)、宫内胎儿死亡(OR,5.1;95% CI,3.7 - 7.2)和胎盘早剥(OR,5.5;95% CI,4.9 - 6.3)的几率更高。此外,这些患者发生早产(OR,2.9;95% CI,2.7 - 3.1)、新生儿死亡(OR,3.1;95% CI,2.3 - 4.2)和婴儿死亡(OR,2.5;95% CI,1.7 - 3.7)的几率也更高。

结论

发现孕期使用甲基苯丙胺与孕产妇和胎儿发病率及死亡率增加的特定模式相关。考虑到这些结果,可以进一步开展工作以改善因使用甲基苯丙胺而并发的妊娠护理,以期减少这些并发症。

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