Maghsoudlou Siavash, Cnattingius Sven, Montgomery Scott, Aarabi Mohsen, Semnani Shahriar, Wikström Anna-Karin, Bahmanyar Shahram
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden.
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
PLoS One. 2017 Apr 27;12(4):e0176588. doi: 10.1371/journal.pone.0176588. eCollection 2017.
Use of narcotic or "recreational" drugs has been associated with adverse pregnancy outcomes such as preterm delivery. However, the associations might be confounded by other factors related to high-risk behaviours. This is the first study to investigate the association between traditional opium use during pregnancy and risk of preterm delivery.
We performed a population-based cohort study in the rural areas of the Golestan province, Iran between 2008 and 2010. We randomly selected 920 women who used (usually smoked) opium during pregnancy and 920 women who did not. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations between the opium use during pregnancy and preterm delivery and adjustment was made for potential confounding factors. This study shows compared with non-use of opium and tobacco, use of only opium during pregnancy was associated with an increased risk of preterm delivery (OR = 1.56; 95% CI 1.05-2.32), and the risk was more than two-fold increased among dual users of opium and tobacco (OR = 2.31; 95% CI 1.37-3.90). We observed that opium use only was associated with a doubled risk for preterm caesarean delivery (OR = 2.05; 95% CI 1.10-3.82) but not for preterm vaginal delivery (OR = 1.25; 95% CI 0.75-2.07). Dual use of opium and tobacco was associated with a substantially increased risk of vaginal preterm delivery (OR = 2.58; 95% CI 1.41-4.71).
Opium use during pregnancy among non-tobacco smokers is associated with an increased risk of preterm caesarean delivery, indicating an increased risk of a compromised foetus before or during labour. Women who use both opium and smoked during pregnancy have an increased risk of preterm vaginal delivery, indicating an increased risk of spontaneous preterm delivery.
使用麻醉药品或“消遣性”毒品与早产等不良妊娠结局有关。然而，这些关联可能会被与高危行为相关的其他因素所混淆。这是第一项调查孕期使用传统鸦片与早产风险之间关联的研究。
2008年至2010年期间，我们在伊朗戈勒斯坦省农村地区开展了一项基于人群的队列研究。我们随机选取了920名孕期使用（通常为吸食）鸦片的女性和920名未使用鸦片的女性。采用逻辑回归模型来估计孕期使用鸦片与早产之间关联的比值比（OR）和95%置信区间（CI），并对潜在的混杂因素进行了调整。本研究表明，与不使用鸦片和烟草相比，孕期仅使用鸦片会增加早产风险（OR = 1.56；95% CI 1.05 - 2.32），而鸦片和烟草双重使用者的风险增加了两倍多（OR = 2.31；95% CI 1.37 - 3.90）。我们观察到，仅使用鸦片与早产剖宫产风险增加一倍有关（OR = 2.05；95% CI 1.10 - 3.82），但与早产阴道分娩风险无关（OR = 1.25；95% CI 0.75 - 2.07）。鸦片和烟草双重使用与阴道早产风险大幅增加有关（OR = 2.58；95% CI 1.41 - 4.71）。
非吸烟者孕期使用鸦片与早产剖宫产风险增加有关，这表明分娩前或分娩期间胎儿受损的风险增加。孕期同时使用鸦片和吸烟的女性阴道早产风险增加，这表明自然早产的风险增加。
