Radwan Alia, Ray Bobbie Nicole, Haas David M
Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Womens Health Rep (New Rochelle). 2020 Sep 24;1(1):375-382. doi: 10.1089/whr.2019.0025. eCollection 2020.
The aim of this study was to examine whether a history of opioid use predicts tier 1 contraceptive use or plan to use in women with infants in the neonatal intensive care unit (NICU) and nursery. We conducted a self-administered, anonymous survey in women with infants in three local NICUs and two postpartum units from November 2018 to May 2019. Women were recruited while visiting their infants in the NICU or in their postpartum rooms. Our survey included adapted questions from the Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire, the National Institute of Drug Abuse (NIDA) Modified ASSIST Screening Tool, and ones written by our team. The questions asked about contraceptive use and opioid use. We compared the responses of women with and without a history of opioid use. We conducted a multivariable regression analysis and applied the backward elimination method to identify whether opioid use was a predictor of tier 1 contraceptive use or plan to use. A total of 122 women completed the survey. Fifty-three women (43.4%) reported opioid use in the month before pregnancy and/or during pregnancy, while 69 (56.6%) women reported no opioid use and comprised the control group. Multivariable regression analysis showed that opioid use was not associated with the use or planned use of tier 1 contraceptives (adjusted odds ratio [aOR] 1.47; confidence interval [95% CI] 0.54-4.01). Older maternal age predicted tier 1 choice (aOR 1.12; 95% CI 1.04-1.21), while African American women were less likely to use or plan to use tier 1 contraceptives compared with white women (aOR 0.21; 95% CI 0.08-0.56). A history of opioid use was not independently associated with women using or planning to use tier 1 methods, while age and race were predictors.
本研究的目的是调查阿片类药物使用史是否能预测新生儿重症监护病房（NICU）和育婴室中有婴儿的女性使用或计划使用一级避孕措施的情况。2018年11月至2019年5月，我们在当地三家NICU和两个产后病房对有婴儿的女性进行了一项自行填写的匿名调查。女性在NICU探视婴儿或在产后病房时被招募。我们的调查包括来自疾病控制与预防中心（CDC）妊娠风险评估监测系统（PRAMS）问卷、国家药物滥用研究所（NIDA）改良的ASSIST筛查工具中的改编问题，以及我们团队编写的问题。问题涉及避孕措施的使用和阿片类药物的使用。我们比较了有和没有阿片类药物使用史的女性的回答。我们进行了多变量回归分析，并应用向后排除法来确定阿片类药物的使用是否是一级避孕措施使用或计划使用的预测因素。共有122名女性完成了调查。53名女性（43.4%）报告在怀孕前一个月和/或怀孕期间使用过阿片类药物，而69名（56.6%）女性报告未使用过阿片类药物，构成对照组。多变量回归分析表明，阿片类药物的使用与一级避孕措施的使用或计划使用无关（调整后的优势比[aOR]为1.47；置信区间[95%CI]为0.54 - 4.01）。产妇年龄较大是一级避孕措施选择的预测因素（aOR为1.12；95%CI为1.04 - 1.21），而与白人女性相比，非裔美国女性使用或计划使用一级避孕措施的可能性较小（aOR为0.21；95%CI为0.08 - 0.56）。阿片类药物使用史与女性使用或计划使用一级避孕措施并无独立关联，而年龄和种族是预测因素。
