Koponen Anne M, Gissler Mika, Nissinen Niina-Maria, Autti-Rämö Ilona, Kahila Hanna, Sarkola Taisto
Department of Public Health, and Social Psychology Unit, Folkhälsan Research Center, and University of Helsinki, Helsinki, Finland.
Information Services Department, Finnish Institute for Health and Welfare, Helsinki, Finland; Research Centre for Child Psychiatry, University of Turku, Turku, Finland; Academic Primary Health Care Centre, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Nordisk Alkohol Nark. 2024 Apr;41(2):156-174. doi: 10.1177/14550725231202074. Epub 2023 Oct 3.
To investigate whether the youth with prenatal substance exposure (PSE) (aged 15-24 years, = 615) had been in hospital care more often due to injuries and poisoning in comparison with unexposed matched controls ( = 1787). Data from medical records (exposure) and national health and social welfare registers (outcome and confounders) were combined and youths were monitored from birth until either outpatient or inpatient hospital care for injury or poisoning, death or the end of the study period (December 2016). Cox regression models were used in the analyses accounting for associated child and maternal risk factors. Half (50.4%) of the exposed group and 40.6% of controls had been in hospital care due to injury or poisoning during the follow-up ( < 0.001). The difference between groups was diminished after controlling for postnatal child and maternal risk factors (hazard ratio [HR] = 0.88, 95% confidence interval [CI] 0.72-1.07, > 0.05). Cumulative adversity, especially out-of-home care in combination with a diagnosed attention or behavioural dysregulation problem, posed the highest risk in both groups (exposed: HR = 1.65, 95% CI 1.24-2.19, < 0.001; controls: HR = 1.84, 95% CI 1.33-2.56, < 0.001). Hospital care for injury and poisoning is more common in youth with PSE, but this is largely explained by the related postnatal child and maternal factors. Long-term support to families with maternal substance abuse problems could prevent injury and poisoning among youth with PSE.
为了调查产前接触物质（PSE）的青少年（年龄在15 - 24岁，n = 615）与未接触物质的匹配对照组（n = 1787）相比，是否因受伤和中毒而更频繁地接受住院治疗。将医疗记录（暴露情况）数据与国家健康和社会福利登记册（结果及混杂因素）数据相结合，对青少年从出生开始进行监测，直至其因受伤或中毒接受门诊或住院治疗、死亡或研究期结束（2016年12月）。分析中使用Cox回归模型，并考虑相关的儿童和母亲风险因素。在随访期间，暴露组中有一半（50.4%）因受伤或中毒接受过住院治疗，而对照组这一比例为40.6%（P < 0.001）。在控制产后儿童和母亲风险因素后，两组之间的差异减小（风险比[HR] = 0.88，95%置信区间[CI] 0.72 - 1.07，P > 0.05）。累积逆境，尤其是家庭外照料与已诊断的注意力或行为失调问题相结合，在两组中都构成了最高风险（暴露组：HR = 1.65，95% CI 1.24 - 2.19，P < 0.001；对照组：HR = 1.84，95% CI 1.33 - 2.56，P < 0.001）。因受伤和中毒接受住院治疗在产前接触物质的青少年中更为常见，但这在很大程度上可由相关的产后儿童和母亲因素来解释。为有母亲药物滥用问题的家庭提供长期支持可以预防产前接触物质的青少年受伤和中毒。
