Department of Psychiatry, University of California, San Diego La Jolla, CA, USA.
School of Social Work, College of Health and Human Services, San Diego State University, San Diego, CA, USA.
J Addict Dis. 2023 Apr-Jun;41(2):137-148. doi: 10.1080/10550887.2022.2082834. Epub 2022 Jun 28.
This article aimed to evaluate whether a substance-related diagnosis (SRD; i.e., alcohol, opioids, cannabis, stimulants, nicotine) predicts the likelihood and co-occurrence of preterm (20-37 weeks' gestation) and cesarean delivery. This study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live or stillbirth at ≥ 20 weeks of gestation from 2012 to 2019. Women with and without an SRD were matched on key demographic characteristics at a 1:1 ratio. Adjusting for covariates, odds ratios and 95% confidence intervals were calculated. Of the 19,346 deliveries, a matched cohort of 2,158 deliveries was identified. Of these, 1,079 (50%) had an SRD, 280 (13%) had a preterm delivery, 833 (39%) had a cesarean delivery, and 166 (8%) had a co-occurring preterm and cesarean delivery. An SRD was significantly associated with preterm and cesarean delivery (AOR = 1.84 [95% CI, 1.41-2.39], -value= <0.0001; AOR = 1.51 [95% CI, 1.23-1.85], -value= <0.0001). An alcohol-related diagnosis (AOR = 1.82 [95% CI, 1.01-3.28], -value= 0.0471), opioid-related diagnosis (AOR = 1.94 [95% CI, 1.26-2.98], -value= 0.0027), stimulant-related diagnosis (AOR = 1.65 [95% CI, 1.11-2.45], -value= 0.0142), and nicotine-related diagnosis (AOR = 1.54 [95% CI, 1.05-2.26], -value= 0.0278) were associated with co-occurring preterm and cesarean delivery. Pregnant women with an SRD experienced disproportionally higher odds of preterm and cesarean delivery compared to pregnant women without an SRD. Substance-type predicts the type of delivery outcome. An SRD in pregnant women should be identified early to reduce potential harm through intervention and treatment.
这篇文章旨在评估物质相关诊断（SRD；即酒精、阿片类药物、大麻、兴奋剂、尼古丁）是否预测早产（20-37 周妊娠）和剖宫产的可能性和同时发生。本研究回顾了 2012 年至 2019 年间电子健康记录中年龄在 18-44 岁之间分娩单胎活产或死胎≥20 周的女性的数据。在 1:1 的比例下，对有和没有 SRD 的女性进行关键人口统计学特征的匹配。调整协变量后，计算比值比和 95%置信区间。在 19346 例分娩中，确定了 2158 例匹配队列的分娩。其中，1079 例（50%）有 SRD，280 例（13%）早产，833 例（39%）行剖宫产，166 例（8%）同时发生早产和剖宫产。SRD 与早产和剖宫产显著相关（AOR=1.84[95%CI，1.41-2.39]，-值<0.0001；AOR=1.51[95%CI，1.23-1.85]，-值<0.0001）。酒精相关诊断（AOR=1.82[95%CI，1.01-3.28]，-值=0.0471）、阿片类药物相关诊断（AOR=1.94[95%CI，1.26-2.98]，-值=0.0027）、兴奋剂相关诊断（AOR=1.65[95%CI，1.11-2.45]，-值=0.0142）和尼古丁相关诊断（AOR=1.54[95%CI，1.05-2.26]，-值=0.0278）与同时发生的早产和剖宫产相关。与没有 SRD 的孕妇相比，有 SRD 的孕妇发生早产和剖宫产的可能性更高。物质类型预测分娩结局的类型。应早期识别孕妇的 SRD，通过干预和治疗降低潜在危害。
