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孕期及产后的物质使用与物质使用障碍

Substance use and use disorders during pregnancy and the postpartum period.

作者信息

Habersham Leah L, Townsel Courtney, Terplan Mishka, Hurd Yasmin L

机构信息

Department of Obstetrics, Gynecology, & Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.

Department of Obstetrics & Gynecology, University of Maryland School of Medicine, Baltimore, MD.

出版信息

Am J Obstet Gynecol. 2025 Apr;232(4):337-353.e1. doi: 10.1016/j.ajog.2025.01.007. Epub 2025 Jan 9.

Abstract

Substance use and substance use disorders among pregnant and postpartum individuals have risen dramatically, necessitating enhanced clinician education and intervention strategies. This expert review offers obstetricians and gynecologists a comprehensive overview of substance use during the prenatal and postpartum periods. We discuss the epidemiology, maternal and fetal adverse effects, as well as treatment approaches for major substances: nicotine, cannabis, alcohol, benzodiazepines, stimulants, and opioids. Additionally, we address the ethical and legal implications of substance use during pregnancy and emphasize the importance of equitable and nonstigmatizing care. By integrating evidence-based practices, we aim to support obstetricians and gynecologists in providing optimal care for pregnant and postpartum individuals affected by substance use disorders.

摘要

孕期和产后人群中的物质使用及物质使用障碍显著增加,这就需要加强临床医生教育和干预策略。本专家综述为产科医生和妇科医生提供了孕期和产后物质使用的全面概述。我们讨论了主要物质(尼古丁、大麻、酒精、苯二氮䓬类药物、兴奋剂和阿片类药物)的流行病学、对母婴的不良影响以及治疗方法。此外,我们阐述了孕期物质使用的伦理和法律影响,并强调公平且无歧视护理的重要性。通过整合循证实践,我们旨在支持产科医生和妇科医生为受物质使用障碍影响的孕期和产后人群提供最佳护理。

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