MMWR Morb Mortal Wkly Rep. 2020 Jul 17;69(28):897-903. doi: 10.15585/mmwr.mm6928a1.
Prescription opioid use during pregnancy has been associated with poor outcomes for mothers and infants. Studies using administrative data have estimated that 14%-22% of women filled a prescription for opioids during pregnancy; however, data on self-reported prescription opioid use during pregnancy are limited.
CDC analyzed 2019 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) survey in 32 jurisdictions and maternal and infant health surveys in two additional jurisdictions not participating in PRAMS to estimate self-reported prescription opioid pain reliever (prescription opioid) use during pregnancy overall and by maternal characteristics among women with a recent live birth. This study describes source of prescription opioids, reasons for use, want or need to cut down or stop use, and receipt of health care provider counseling on how use during pregnancy can affect an infant.
An estimated 6.6% of respondents reported prescription opioid use during pregnancy. Among these women, 21.2% reported misuse (a source other than a health care provider or a reason for use other than pain), 27.1% indicated wanting or needing to cut down or stop using, and 68.1% received counseling from a provider on how prescription opioid use during pregnancy could affect an infant.
Among respondents reporting opioid use during pregnancy, most indicated receiving prescription opioids from a health care provider and using for pain reasons; however, answers from one in five women indicated misuse. Improved screening for opioid misuse and treatment of opioid use disorder in pregnant patients might prevent adverse outcomes. Implementation of public health strategies (e.g., improving state prescription drug monitoring program use and enhancing provider training) can support delivery of evidence-based care for pregnant women.
孕期使用处方类阿片与母婴不良结局有关。使用行政数据的研究估计，14%-22%的孕妇曾开具处方类阿片；然而，关于孕期自我报告处方类阿片使用的数据有限。
疾病预防控制中心（CDC）分析了来自 32 个司法管辖区的 2019 年妊娠风险评估监测系统（PRAMS）调查和另外两个未参与 PRAMS 的司法管辖区的母婴健康调查数据，以估计总体和按产妇特征报告的近期活产后孕妇自我报告处方类阿片止痛药（处方类阿片）使用情况。本研究描述了处方类阿片的来源、使用原因、减少或停止使用的意愿或需求，以及获得医疗保健提供者关于孕期使用如何影响婴儿的咨询情况。
估计有 6.6%的受访者报告在孕期使用过处方类阿片。在这些女性中，21.2%报告了误用（来源非医疗保健提供者或使用原因非疼痛），27.1%表示希望或需要减少或停止使用，68.1%接受了提供者关于孕期使用处方类阿片如何影响婴儿的咨询。
在报告孕期使用阿片类药物的受访者中，大多数人表示从医疗保健提供者处获得处方类阿片并用于缓解疼痛；然而，五分之一的女性回答表示误用。改善对阿片类药物误用的筛查和对孕妇阿片类药物使用障碍的治疗可能预防不良结局。实施公共卫生策略（例如，改进州处方药物监测计划的使用和加强提供者培训）可以为孕妇提供基于证据的护理。
