Muskie School of Public Service, University of Southern Maine, Portland, ME, USA.
Division of Applied Health Care Delivery Science, Department of Medicine, Maine Medical Center, Portland, ME, USA.
Public Health. 2020 Apr;181:171-179. doi: 10.1016/j.puhe.2019.12.014. Epub 2020 Feb 28.
A multistate analysis found Maine had the second highest average annual increase in maternal opioid use disorder (OUD) at delivery hospitalization during 1999-2012. The objective of our analysis was to estimate the prevalence, maternal characteristics, and geographic distribution of OUD at delivery hospitalization in Maine using recent state-level data.
Serially collected cross-sectional population-based data.
We used diagnosis and procedure codes to identify deliveries among hospital discharges in Maine, 2009-2018 (n = 120,764), and to categorize deliveries according to the prevalence of maternal OUD and selected conditions. We assessed linear trends in OUD at delivery and calculated prevalence ratios (PR) for co-occurring maternal conditions.
The prevalence of maternal OUD per 1000 deliveries in Maine increased from 22.7 in 2009 to 34.9 in 2018 (linear trend P value < 0.01), with a mean annual increase of 1.6 (95% confidence interval [CI]: 0.9 to 2.4). The following conditions were more prevalent among women with OUD at delivery: hepatitis C, PR = 45.8 (95% CI: 38.8 to 54.2); other drug abuse or dependence, PR = 16.8 (13.4 to 20.9); alcohol abuse and dependence, PR = 8.5 (5.8 to 12.5); nicotine use, PR = 6.0 (5.9 to 6.2); cannabis use, PR = 5.2 (4.6 to 5.9); anxiety, PR = 2.7 (2.5 to 3.2); and depression, PR = 2.7 (2.4 to 3.1). Women with OUD at delivery were also more likely to reside in small rural areas (27.3% vs 22.5%) and deliver in a hospital with a level III nursery (50.6% vs 34.9%).
Maternal OUD now accounts for 1 in 29 deliveries in Maine and commonly occurs with other medical conditions. Prevention and treatment of OUD among reproductive age women in Maine remains needed.
一项多州分析发现，1999 年至 2012 年期间，缅因州产妇阿片类药物使用障碍（OUD）在分娩住院期间的年平均增长率位居第二。本分析的目的是利用最近的州级数据，估计缅因州分娩时 OUD 的流行率、产妇特征和地域分布。
连续收集的横断面人群基础数据。
我们使用诊断和程序代码在缅因州的医院出院记录中确定分娩病例（n=120764），并根据产妇 OUD 和选定条件的流行率对分娩病例进行分类。我们评估了分娩时 OUD 的线性趋势，并计算了同时发生的产妇情况的患病率比（PR）。
缅因州每 1000 例分娩中 OUD 的患病率从 2009 年的 22.7 例增加到 2018 年的 34.9 例（线性趋势 P 值<0.01），平均年增长率为 1.6（95%置信区间[CI]：0.9 至 2.4）。在分娩时患有 OUD 的女性中，以下情况更为常见：丙型肝炎，PR=45.8（95%CI：38.8 至 54.2）；其他药物滥用或依赖，PR=16.8（13.4 至 20.9）；酒精滥用和依赖，PR=8.5（5.8 至 12.5）；尼古丁使用，PR=6.0（5.9 至 6.2）；大麻使用，PR=5.2（4.6 至 5.9）；焦虑，PR=2.7（2.5 至 3.2）；抑郁，PR=2.7（2.4 至 3.1）。分娩时患有 OUD 的女性也更有可能居住在小型农村地区（27.3%比 22.5%），并在具有 III 级婴儿室的医院分娩（50.6%比 34.9%）。
现在，缅因州每 29 次分娩中就有 1 次是产妇 OUD，而且这种情况通常与其他医疗条件同时发生。在缅因州，仍需要预防和治疗育龄妇女的 OUD。
