Marian P. Jarlenski ( marian. jarlenski@pitt. edu ) is an assistant professor in the Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, in Pennsylvania.
Elizabeth E. Krans is an assistant professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, and at the Magee-Womens Research Institute, in Pittsburgh.
Health Aff (Millwood). 2020 Feb;39(2):247-255. doi: 10.1377/hlthaff.2019.00740.
The health of women and children affected by opioid use disorder is a priority for state Medicaid programs. Little is known about longer-term outcomes among Medicaid-enrolled children exposed to opioids in utero. We examined well-child visit use and diagnoses of pediatric complex chronic conditions in the first five years of life among children with opioid exposure, tobacco exposure, or neither exposure in utero. The sample consisted of 82,329 maternal-child dyads in the Pennsylvania Medicaid program in which the children were born in the period 2008-11 and followed up for five years. Children with in utero opioid exposure had a lower predicted probability of recommended well-child visit use at age fifteen months (42.1 percent) compared to those with tobacco exposure (54.1 percent) and those with neither exposure (55.7 percent). Children with in utero opioid exposure had a predicted probability of being diagnosed with a pediatric complex chronic condition similar to that among children with tobacco exposure and those with neither exposure (20.4 percent, 18.7 percent, and 20.2 percent, respectively). Our findings were consistent when we examined a subgroup of opioid-exposed children identified as having neonatal opioid withdrawal symptoms.
受阿片类药物使用障碍影响的妇女和儿童的健康是州医疗补助计划的重点。对于在子宫内接触阿片类药物的医疗补助计划所涵盖的儿童的长期后果，人们知之甚少。我们研究了在子宫内接触阿片类药物、烟草暴露或两者都不暴露的儿童在生命的前五年中进行常规儿童保健就诊的使用情况和儿科复杂慢性病的诊断情况。该样本包括宾夕法尼亚州医疗补助计划中的 82329 对母婴对子，这些儿童出生于 2008-11 年期间，并随访了五年。与烟草暴露（54.1%）和两者都不暴露（55.7%）的儿童相比，在子宫内接触阿片类药物的儿童在 15 个月时接受推荐的常规儿童保健就诊的预测概率较低（42.1%）。与烟草暴露和两者都不暴露的儿童相比，在子宫内接触阿片类药物的儿童被诊断为儿科复杂慢性病的预测概率相似（分别为 20.4%、18.7%和 20.2%）。当我们检查被确定为患有新生儿阿片类戒断症状的阿片类药物暴露儿童亚组时，我们的发现是一致的。
