Abstract

Objective

This study examines the associations of substance use disorders in pregnancy with a set of neonatal outcomes.

Methods

This is a quantitative retrospective study. Three linked datasets of a 10-year period (2007–2016) from New South Wales, Australia, were examined. Pregnant women were identified positive for substance use disorders when at least one hospital admission during pregnancy or delivery had opioid-, or cannabis-, or stimulant-, or alcohol- or two or more of the four substance groups- related ICD-10-AM diagnostic code. As there was a hierarchical structure in the dataset, the adjusted odds ratio (AOR) was estimated using multilevel logistic regression.

Findings

Of the 622,640 birth records, 1677 (0.27%) women had opioid-related, 1857 (0.30%) had cannabis-related, 552 (0.09%) had stimulant-related, 595 (0.10%) had alcohol-related and 591 (0.09%) had polysubstance-related ICD-10-AM diagnostic codes. There were significant relationships between opioid use in pregnancy and neonatal health outcomes including preterm birth (AOR 3.2; 95% CI 2.8, 3.7) and admission to the neonatal intensive care unit (NICU) (AOR 10.0; 95% CI 8.8, 11.3). Substance use disorders due to cannabis, stimulants, alcohol or polysubstance were significantly associated with preterm birth, low birthweight, low APGAR score and admission to NICU. Also, alcohol and polysubstance use disorders in pregnancy were found to be significantly associated with stillbirth.

Conclusion

Results demonstrate that substance use disorders in pregnancy are associated with an increased risk of adverse neonatal outcomes. Early identification of substance use disorders through screening and adherence to pharmacotherapy and other psychosocial interventions could improve neonatal outcomes.

中文翻译：

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患有物质使用障碍的孕妇所生婴儿的新生儿结局：关联数据的多层次分析

摘要

客观的

本研究探讨了妊娠期物质使用障碍与一系列新生儿结局之间的关系。

方法

这是一项定量回顾性研究。对来自澳大利亚新南威尔士州的 10 年期间（2007-2016 年）的三个相关数据集进行了检查。如果在怀孕或分娩期间至少有一次入院时有阿片类药物、大麻、兴奋剂、酒精或四种物质组相关 ICD-10-AM 中的两种或两种以上，则孕妇被确定为物质使用障碍阳性诊断代码。由于数据集中存在层次结构，因此使用多级逻辑回归估计调整后的优势比 (AOR)。

发现

在 622,640 份出生记录中，1677 名（0.27%）女性与阿片类药物相关，1857 名（0.30%）与大麻相关，552 名（0.09%）与兴奋剂相关，595 名（0.10%）与酒精相关，591 名（0.09 %) 具有与多物质相关的 ICD-10-AM 诊断代码。妊娠期阿片类药物使用与新生儿健康结局之间存在显着关系，包括早产（AOR 3.2；95% CI 2.8, 3.7）和入住新生儿重症监护病房（NICU）（AOR 10.0；95% CI 8.8, 11.3）。由大麻、兴奋剂、酒精或多种物质引起的物质使用障碍与早产、低出生体重、低 APGAR 评分和入住 NICU 显着相关。此外，发现妊娠期酒精和多种物质使用障碍与死产显着相关。

结论

结果表明，妊娠期物质使用障碍与新生儿不良结局风险增加有关。通过筛查和坚持药物治疗和其他社会心理干预来早期识别物质使用障碍可以改善新生儿结局。