Objective To examine whether maternal opioid treatment after delivery is associated with an increased risk of adverse infant outcomes. Design Population based cohort study. Setting Ontario, Canada. Participants 865 691 mother-infant pairs discharged from hospital alive within seven days of delivery from 1 September 2012 to 31 March 2020. Each mother who filled an opioid prescription within seven days of discharge was propensity score matched to a mother who did not. Main outcome measures The primary outcome was hospital readmission of infants for any reason within 30 days of their mother filling an opioid prescription (index date). Infant related secondary outcomes were any emergency department visit, hospital admission for all cause injury, admission to a neonatal intensive care unit, admission with resuscitation or assisted ventilation, and all cause death. Results 85 675 mothers (99.8% of the 85 852 mothers prescribed an opioid) who filled an opioid prescription within seven days of discharge after delivery were propensity score matched to 85 675 mothers who did not. Of the infants admitted to hospital within 30 days, 2962 (3.5%) were born to mothers who filled an opioid prescription compared with 3038 (3.5%) born to mothers who did not. Infants of mothers who were prescribed an opioid were no more likely to be admitted to hospital for any reason than infants of mothers who were not prescribed an opioid (hazard ratio 0.98, 95% confidence interval 0.93 to 1.03) and marginally more likely to be taken to an emergency department in the subsequent 30 days (1.04, 1.01 to 1.08), but no differences were found for any other adverse infant outcomes and there were no infant deaths. Conclusions Findings from this study suggest no association between maternal opioid prescription after delivery and adverse infant outcomes, including death. The dataset from this study is held securely in coded form at ICES. Although legal data sharing agreements between ICES and data providers (eg, healthcare organisations and governments) prohibit ICES from making the dataset publicly available, access may be granted to those who meet prespecified criteria for confidential access, available at (das@ices.on.ca). The full dataset creation plan and underlying analytical code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification. The study also used data adapted from the Statistics Canada Postal CodeOM Conversion File, which is based on data licensed from Canada Post Corporation, and/or data adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license from Canada Post and Statistics Canada.

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产后母亲阿片类药物治疗和婴儿不良结局的风险：基于人群的队列研究

目的 研究母亲产后阿片类药物治疗是否与婴儿不良结局风险增加相关。设计基于人群的队列研究。设定加拿大安大略省。2012 年 9 月 1 日至 2020 年 3 月 31 日期间，共有 865 691 对母婴在分娩后 7 天内活着出院。每位在出院 7 天内服用阿片类药物处方的母亲与未服用阿片类药物的母亲进行倾向评分匹配。主要结局指标 主要结局指标是婴儿在母亲服用阿片类药物处方后 30 天内（索引日期）因任何原因重新入院。婴儿相关的次要结局包括急诊就诊、因全因损伤入院、入住新生儿重症监护病房、入院接受复苏或辅助通气以及全因死亡。结果 85 675 名在产后出院后 7 天内服用阿片类药物处方的母亲（85 852 名服用阿片类药物的母亲中的 99.8%）与 85 675 名未服用阿片类药物的母亲进行了倾向评分匹配。在 30 天内入院的婴儿中，有 2,962 名（3.5%）是由服用阿片类药物处方的母亲所生，而 3038 名（3.5%）是由未服用阿片类药物的母亲所生。服用阿片类药物的母亲的婴儿因任何原因入院的可能性并不高于未服用阿片类药物的母亲的婴儿（风险比 0.98，95% 置信区间 0.93 至 1.03），并且服用阿片类药物的可能性稍高在随后的 30 天内（1.04、1.01 至 1.08）前往急诊室，但没有发现任何其他不良婴儿结局的差异，也没有婴儿死亡。结论 这项研究的结果表明，母亲产后阿片类药物处方与婴儿不良结局（包括死亡）之间没有关联。本研究的数据集以编码形式安全地保存在 ICES 中。尽管 ICES 和数据提供者（例如医疗保健组织和政府）之间的法律数据共享协议禁止 ICES 公开提供数据集，但可以向符合预先指定的保密访问标准的人员授予访问权限，该标准可在（das@ices.on.ca）。作者可根据要求提供完整的数据集创建计划和基础分析代码，并了解计算机程序可能依赖于 ICES 特有的编码模板或宏，因此无法访问或可能需要修改。该研究还使用了改编自加拿大统计局邮政编码 OM 转换文件的数据，该文件基于加拿大邮政公司许可的数据，和/或改编自安大略省卫生部邮政编码转换文件的数据，其中包含根据加拿大许可复制的数据加拿大邮政和统计局。