Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; National Monitoring Centre for Drugs and Addiction, Office of the Government, Prague, Czech Republic.
Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Drug Alcohol Depend. 2020 Apr 1;209:107933. doi: 10.1016/j.drugalcdep.2020.107933. Epub 2020 Feb 20.
Maternal substance use can pose a risk to the fetal health. We studied the background characteristics of women with substance use disorders (SUDs) and selected neonatal outcomes in their children.
A database-linkage study was performed. The sample consisted of pregnant women with a SUD during pregnancy (ICD-10 diagnosis F10-F19 except F17, n = 1710), women not diagnosed with a SUD (n = 1,511,310) in Czechia in 2000-2014, and their children. The monitored neonatal outcomes were gestational age, birth weight, preterm birth, and small-for-gestational age (SGA). Binary logistic regression adjusted for age, marital status, education, concurrent substance use, and prenatal care was performed.
Women with illicit SUDs were younger, more often unmarried, with a lower level of education, a higher abortion rate, a higher smoking rate, and lower compliance to prenatal care than women with a SUD related to alcohol, or sedatives and hypnotics (SH). Women with a SUD had worse socioeconomic situations, poorer pregnancy care, and worse neonatal outcomes than women without a SUD. After adjustment, we found no difference in SGA between the illicit SUD groups and the alcohol and the SH groups. The newborns from all SUD groups had a higher risk of SGA when compared to women without a SUD. However after adjustment, the difference remained significant just in the alcohol group (OR = 1.9, 95 % CI = 1.4-2.6).
Mother's SUD during pregnancy increased risk of fetal growth restriction as measured by SGA. The role of maternal socioeconomic and lifestyle factors for the risk of SGA was substantial.
母体物质使用会对胎儿健康造成风险。我们研究了患有物质使用障碍（SUD）的女性的背景特征，并选择了其子女的新生儿结局。
进行了一项数据库链接研究。该样本包括 2000 年至 2014 年期间在捷克患有妊娠期间物质使用障碍（ICD-10 诊断 F10-F19 除外 F17，n=1710）的孕妇、未被诊断为 SUD 的孕妇（n=1,511,310）及其子女。监测的新生儿结局包括胎龄、出生体重、早产和小于胎龄儿（SGA）。采用二元逻辑回归调整年龄、婚姻状况、教育程度、同期物质使用和产前保健情况进行分析。
与酒精或镇静催眠药（SH）相关的 SUD 相比，患有非法 SUD 的女性更年轻、未婚比例更高、受教育程度更低、堕胎率更高、吸烟率更高、产前保健依从性更低。与没有 SUD 的女性相比，患有 SUD 的女性社会经济状况较差、妊娠保健较差、新生儿结局较差。调整后，我们发现非法 SUD 组与酒精和 SH 组之间在 SGA 方面没有差异。与没有 SUD 的女性相比，所有 SUD 组的新生儿发生 SGA 的风险更高。然而，调整后，这种差异仅在酒精组中仍然显著（OR=1.9，95%CI=1.4-2.6）。
母亲在怀孕期间的 SUD 增加了 SGA 所测胎儿生长受限的风险。母亲的社会经济和生活方式因素对 SGA 的风险有重要作用。
