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斯堪的纳维亚国家孕妇的阿片类药物维持治疗。

Opioid maintenance treatment of pregnant women in the Scandinavian countries.

作者信息

Handal Marte, Skurtveit Svetlana, Mahic Milada, Øhman Inger, Wikner Birgitta Norstedt, Tjagvad Christian, Kieler Helle, Halmesmäki Erja, Lund Ingunn Olea

机构信息

Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.

Centre for Pharmacoepidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.

出版信息

Nordisk Alkohol Nark. 2020 Jun;37(3):298-312. doi: 10.1177/1455072520914114. Epub 2020 Apr 13.

Abstract

BACKGROUND

WHO guidelines emphasise the need for descriptions of clinical practice and observational studies on risk and benefits of pharmacotherapies in pregnancy. The aims of the present study were to: (1) Describe opioid maintenance treatment (OMT) in the Scandinavian countries in general, and specifically for pregnant women, (2) Describe a project which utilises a new approach using registry-linkage data to examine associations between prenatal exposure to OMT and child outcomes: a Scandinavian cohort study of pregnant women in OMT during pregnancy (ScopeOMT).

DATA

Guidelines describing the treatment of persons with opioid use disorders in general, and specifically for pregnant women. Scandinavian registry-linkage data from ScopeOMT.

RESULTS

Registry data show that approximately 800 pregnant women received OMT during pregnancy in the period of the ScopeOMT study. Similarities across the Scandinavian countries include access to free healthcare and treatment; multidisciplinary teams trained to support pregnant women in OMT; buprenorphine as the recommended drug when initiating therapy; and a holistic focus on the patients' lives. An important difference is that Norwegian women who use illegal substances that may harm the foetus may be admitted - voluntarily, or against their will - for parts of, or the remainder of the pregnancy to inpatient treatment at specialised clinics.

CONCLUSION

Many similarities in the treatment provided to opioid-dependent persons in the Scandinavian countries place this area in an excellent position to combine the efforts and carry out observational studies concerning the safety of OMT during pregnancy.

摘要

背景

世界卫生组织的指南强调需要对妊娠期药物治疗的风险和益处进行临床实践描述及观察性研究。本研究的目的是:(1)总体描述斯堪的纳维亚国家的阿片类药物维持治疗(OMT)情况,特别是针对孕妇的情况;(2)描述一个利用新方法通过登记链接数据来研究产前暴露于OMT与儿童结局之间关联的项目:一项针对孕期接受OMT的孕妇的斯堪的纳维亚队列研究(ScopeOMT)。

数据

关于阿片类药物使用障碍患者总体治疗,特别是针对孕妇治疗的指南。来自ScopeOMT的斯堪的纳维亚登记链接数据。

结果

登记数据显示,在ScopeOMT研究期间,约有800名孕妇在孕期接受了OMT。斯堪的纳维亚国家的相似之处包括可获得免费医疗保健和治疗;有多学科团队接受培训以支持接受OMT的孕妇;开始治疗时推荐使用丁丙诺啡;以及对患者生活的全面关注。一个重要的差异是,使用可能危害胎儿的非法物质的挪威女性可能会在孕期的部分时间或剩余时间被自愿或非自愿地收治到专门诊所接受住院治疗。

结论

斯堪的纳维亚国家在为阿片类药物依赖者提供治疗方面有许多相似之处,这使得该领域处于有利地位,能够整合各方力量并开展关于孕期OMT安全性的观察性研究。

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