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新墨西哥州 2015-2019 年与物质使用障碍相关的死亡和孕产妇死亡率。

Substance Use Disorder-Related Deaths and Maternal Mortality in New Mexico, 2015-2019.

机构信息

New Mexico Department of Health, 2040 S. Pacheco St, Santa Fe, NM, 87505, USA.

Department of Internal Medicine, University of New Mexico School of Medicine, 1 University of New Mexico, Albuquerque, NM, 8713, USA.

出版信息

Matern Child Health J. 2023 Dec;27(Suppl 1):23-33. doi: 10.1007/s10995-023-03691-8. Epub 2023 Jun 12.

Abstract

BACKGROUND

In recent decades, maternal mortality has increased across the U.S. Experiences of pregnant and postpartum people with Substance Use Disorder (SUD)-related deaths have not been previously evaluated in New Mexico. The aim of this study was to analyze risk factors related to substance use and explore substance use patterns among pregnancy-associated deaths in New Mexico from 2015 to 2019.

METHODS

We conducted an analysis of pregnancy-associated deaths to assess the association between demographics, pregnancy factors, circumstances surrounding death, treatment of mental health conditions, and experiences with social stressors among Substance Use Disorder (SUD)-related and non-SUD-related deaths. We performed univariate analyses of risk factors using chi-square tests to assess the differences between SUD-related and non-SUD-related deaths. We also examined substance use at time of death.

RESULTS

People with SUD-related deaths were more likely to die 43-365 days postpartum (81% vs. 45%, p-value = 0.002), have had a primary cause of death of mental health conditions (47% vs 10%, p < 0.001), have died of an overdose (41% vs. 8%, p-value = 0.002), have had experienced any social stressors (86% vs 30%, p < 0.001) compared to people with non-SUD-related deaths, and received treatment for SUD at any point before, during, or after pregnancy (49% vs. 2%, p < 0.001). The substances most used at time of death were amphetamines (70%), and most cases engaged in polysubstance use (63%).

CONCLUSIONS FOR PRACTICE

Providers, health departments, and community organizations must prioritize supporting people using substances during and after pregnancy to prevent death and improve quality of life for pregnant and postpartum people.

摘要

背景

近几十年来,美国的孕产妇死亡率一直在上升。新墨西哥州以前从未评估过患有物质使用障碍(SUD)相关死亡的孕妇和产后人群的经历。本研究的目的是分析与物质使用相关的风险因素,并探讨 2015 年至 2019 年新墨西哥州与妊娠相关的死亡中物质使用模式。

方法

我们对与妊娠相关的死亡进行了分析,以评估人口统计学、妊娠因素、死亡环境、精神健康状况的治疗以及物质使用障碍(SUD)相关和非 SUD 相关死亡中社会压力源经历之间的关联。我们使用卡方检验对风险因素进行了单变量分析,以评估 SUD 相关和非 SUD 相关死亡之间的差异。我们还检查了死亡时的物质使用情况。

结果

SUD 相关死亡的人更有可能在产后 43-365 天死亡(81%比 45%,p 值=0.002),主要死因是精神健康状况(47%比 10%,p<0.001),死于过量(41%比 8%,p 值=0.002),经历过任何社会压力源(86%比 30%,p<0.001),与非 SUD 相关死亡相比,在怀孕前、怀孕中和怀孕后任何时候都接受过 SUD 治疗(49%比 2%,p<0.001)。死亡时使用最多的物质是安非他命(70%),大多数病例涉及多药物使用(63%)。

实践结论

提供者、卫生部门和社区组织必须优先支持怀孕期间和之后使用物质的人,以预防死亡并提高孕妇和产后人群的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98f3/10691991/fe98b5b8f8ab/10995_2023_3691_Fig1_HTML.jpg

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