Hussaini Khaleel, Yocher George
Division of Public Health, Delaware Department of Health and Social Services; Division of Reproductive Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
Division of Public Health, Delaware Department of Health and Social Services.
Dela J Public Health. 2023 Jun 12;9(2):134-140. doi: 10.32481/djph.2023.06.025. eCollection 2023 Jun.
Assess differences in postpartum contraceptive use and pregnancy intentions in women with a recent live birth who delivered a neonatal abstinence syndrome (NAS) affected infant.
Using linked Delaware Birth Certificate Data, Hospital Discharge Data and PRAMS data for 2012-2018 (n = 6,358 singleton births), we assessed differences among women with and without a delivery of an NAS-affected infant by effective postpartum contraceptive use and pregnancy intentions. We calculated prevalence estimates, crude (cPOR), and prevalence odds ratios adjusted (aPOR) for NAS by maternal characteristics. We used alpha ≤ 0.05 to determine statistical significance.
Prevalence of NAS was 2.2% (95% CI: 1.8 - 2.6). Effective postpartum contraceptive use was 60.4% (95% CI: 51.9-69.0) among women with delivery of an NAS-affected infant compared with a non-NAS delivery 56.4% (95% CI: 55.1-57.8%) and cPOR was 1.2 (95% CI: 0.8-1.7). Prevalence of intended pregnancy was 26.5% (95% CI: 18.9-34.0) among women with delivery of an NAS-affected infant compared with a non-NAS delivery 53.0% (95% CI: 51.7-54.4) and cPOR was 0.3 (95% CI: 0.2-0.5). After adjustment, women who delivered an NAS-affected infant had lower odds (aPOR = 0.5; 95% CI: 0.3-0.8) of indicating that their pregnancy was intended as compared to those who did not deliver an NAS-affected infant.
Our study found no association between delivery of an NAS-affected infant and use of an effective postpartum contraceptive method. However, we found that pregnancy intendedness was lower among women delivering an NAS-affected infant compared with women without an NAS delivery even after accounting for maternal characteristics.
评估近期有活产且分娩出患有新生儿戒断综合征（NAS）婴儿的女性在产后避孕措施使用情况及妊娠意愿方面的差异。
利用2012 - 2018年特拉华州出生证明数据、医院出院数据和PRAMS数据（n = 6358例单胎分娩），我们通过有效的产后避孕措施使用情况和妊娠意愿，评估了分娩出受NAS影响婴儿的女性与未分娩出此类婴儿的女性之间的差异。我们计算了NAS的患病率估计值、粗患病率（cPOR）以及按母亲特征调整后的患病率比值比（aPOR）。我们使用α≤0.05来确定统计学显著性。
NAS的患病率为2.2%（95%置信区间：1.8 - 2.6）。分娩出受NAS影响婴儿的女性中，有效的产后避孕措施使用率为60.4%（95%置信区间：51.9 - 69.0），而未分娩出受NAS影响婴儿的女性这一比例为56.4%（95%置信区间：55.1 - 57.8%），粗患病率比值为1.2（95%置信区间：0.8 - 1.7）。分娩出受NAS影响婴儿的女性中，计划妊娠的患病率为26.5%（95%置信区间：18.9 - 34.0），而未分娩出受NAS影响婴儿的女性这一比例为53.0%（95%置信区间：51.7 - 54.4），粗患病率比值为0.3（95%置信区间：0.2 - 0.5）。调整后，与未分娩出受NAS影响婴儿的女性相比，分娩出受NAS影响婴儿的女性表示其妊娠为计划内妊娠的几率较低（调整后的患病率比值比 = 0.5；95%置信区间：0.3 - 0.8）。
我们的研究发现，分娩出受NAS影响的婴儿与使用有效的产后避孕方法之间没有关联。然而，我们发现，即使在考虑了母亲特征之后，分娩出受NAS影响婴儿的女性的妊娠意愿仍低于未分娩出受NAS影响婴儿的女性。
