Reitan Therese
Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden.
Nordisk Alkohol Nark. 2017 Apr;34(2):145-159. doi: 10.1177/1455072516687256. Epub 2017 Mar 30.
Studies of drug use during pregnancy have generally focused on individual substances or specific combinations of drugs. The aim of this article is to increase our knowledge about polydrug use and pregnancy in a Nordic context by describing the sociodemographic characteristics of a clinical population of pregnant women with severe substance use, examining the scope and type of polydrug use and analysing factors associated with concurrent use of many, as opposed to a few, drugs.
A cross-sectional study of pregnant women on admission to compulsory care for substance abuse in Sweden between 2000 and 2009 ( = 119 women, representing 128 pregnancies). Data were retrieved from administrative registers and client records. Univariate links between demographic, social, obstetrical, treatment history variables and polydrug use were examined. Binary logistic regression was used to analyse the association between explanatory variables and polydrug use.
The average number of drugs being used concurrently was 2.65, and injection drug use was recorded in 73% of the pregnancies. Opiates and amphetamines were the most common primary drugs, followed by alcohol. The likelihood of polydrug use increased with first trimester pregnancy, planned (as opposed to emergency) committals, as well as the combination of partner substance abuse and injection drug use.
Polydrug use was widespread among pregnant substance abusers. Policies, interventions and research often focus on individual drugs separately, but for clinical populations in particular there is a need to address drug use broadly, including a systematic recording of smoking habits. This also entails awarding more attention to those not eligible for established interventions, such as opiate maintenance treatment, and giving more consideration to a variety of life circumstances, such as partner drug use.
孕期药物使用研究通常聚焦于单一物质或特定药物组合。本文旨在通过描述严重药物滥用孕妇临床群体的社会人口学特征、审视多药滥用的范围和类型，并分析与同时使用多种而非少数药物相关的因素，增进我们对北欧背景下多药滥用与妊娠情况的了解。
对2000年至2009年间在瑞典因药物滥用而接受强制治疗的孕妇进行横断面研究（n = 119名女性，代表128次妊娠）。数据从行政登记册和客户记录中获取。研究了人口统计学、社会、产科、治疗史变量与多药滥用之间的单变量联系。采用二元逻辑回归分析解释变量与多药滥用之间的关联。
同时使用的药物平均数量为2.65种，73%的妊娠记录有注射吸毒情况。阿片类药物和苯丙胺类药物是最常见的主要药物，其次是酒精。多药滥用的可能性随着孕早期、计划内（而非紧急）入院治疗，以及伴侣药物滥用和注射吸毒的组合而增加。
多药滥用在滥用药物的孕妇中很普遍。政策、干预措施和研究通常分别关注单一药物，但特别是对于临床群体，有必要广泛应对药物使用问题，包括系统记录吸烟习惯。这还需要更多关注那些不符合既定干预条件的人群，如阿片类药物维持治疗，以及更多考虑各种生活情况，如伴侣药物使用情况。
