Maternal and infant characteristics associated with maternal opioid overdose in the year following delivery.
Adult
Cohort Studies
Datasets as Topic
Facilities and Services Utilization
/ statistics & numerical data
Female
Humans
Infant
Infant, Newborn
Information Storage and Retrieval
Live Birth
/ epidemiology
Massachusetts
Neonatal Abstinence Syndrome
/ diagnosis
Opiate Overdose
/ epidemiology
Opiate Substitution Treatment
/ statistics & numerical data
Opioid-Related Disorders
/ diagnosis
Postpartum Period
Pregnancy
Retrospective Studies
Maternal
neonatal abstinence syndrome
non-fatal
opioid use disorder
overdose
postpartum
pregnancy
women
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
23
01
2019
revised:
29
04
2019
accepted:
03
09
2019
pubmed:
7
11
2019
medline:
20
1
2021
entrez:
7
11
2019
Statut:
ppublish
Résumé
Opioid-related overdose is increasingly linked to pregnancy-associated deaths, but factors associated with postpartum overdose are unknown. We aimed to estimate the strength of the association between maternal and infant characteristics and postpartum opioid-related overdose. Retrospective cohort study using a linked, population-level data set. Massachusetts, United States. Among women who delivered live infants in Massachusetts, USA between 2012 and 2014, maternal diagnosis of OUD, prior non-fatal overdose, infant diagnosis of NAS and high unscheduled health-care utilization appeared to be positively associated with postpartum opioid overdose. However, more than half of postpartum overdoses in that period were to women without a diagnosis of OUD. Engagement in methadone or buprenorphine treatment in the month prior to delivery was not sufficient to reduce the odds of postpartum overdose. Women who delivered one or more live births from 2012 to 2014 (n = 174 517). The primary outcome was opioid-related overdose in the postpartum year. We used multivariable logistic regression to explore the independent associations of maternal (demographics, substance use, pregnancy) and infant [gestational age, birthweight, neonatal abstinence syndrome (NAS)] characteristics with postpartum opioid overdose. Findings were stratified by maternal opioid use disorder (OUD) diagnosis. There were 189 deliveries to women who experienced ≥ 1 opioid overdose in the first year postpartum (11 of 10 000 deliveries). Among women with postpartum opioid overdose, 46.6% had an OUD diagnosis within 12 months before delivery. In our adjusted model, maternal diagnosis of OUD [adjusted odds ratio (aOR) = 3.61, 95% confidence interval (CI) = 1.73-7.51] and prior non-fatal overdose (aOR = 2.40, 95% CI = 1.11-5.17) were most strongly associated with postpartum overdose. After stratifying by OUD status, infant diagnosis of NAS (OUD
Sections du résumé
BACKGROUND AND AIMS
Opioid-related overdose is increasingly linked to pregnancy-associated deaths, but factors associated with postpartum overdose are unknown. We aimed to estimate the strength of the association between maternal and infant characteristics and postpartum opioid-related overdose.
DESIGN
Retrospective cohort study using a linked, population-level data set.
SETTING
Massachusetts, United States.
CONCLUSION
Among women who delivered live infants in Massachusetts, USA between 2012 and 2014, maternal diagnosis of OUD, prior non-fatal overdose, infant diagnosis of NAS and high unscheduled health-care utilization appeared to be positively associated with postpartum opioid overdose. However, more than half of postpartum overdoses in that period were to women without a diagnosis of OUD. Engagement in methadone or buprenorphine treatment in the month prior to delivery was not sufficient to reduce the odds of postpartum overdose.
PARTICIPANTS
Women who delivered one or more live births from 2012 to 2014 (n = 174 517).
MEASUREMENTS
The primary outcome was opioid-related overdose in the postpartum year. We used multivariable logistic regression to explore the independent associations of maternal (demographics, substance use, pregnancy) and infant [gestational age, birthweight, neonatal abstinence syndrome (NAS)] characteristics with postpartum opioid overdose. Findings were stratified by maternal opioid use disorder (OUD) diagnosis.
FINDINGS
There were 189 deliveries to women who experienced ≥ 1 opioid overdose in the first year postpartum (11 of 10 000 deliveries). Among women with postpartum opioid overdose, 46.6% had an OUD diagnosis within 12 months before delivery. In our adjusted model, maternal diagnosis of OUD [adjusted odds ratio (aOR) = 3.61, 95% confidence interval (CI) = 1.73-7.51] and prior non-fatal overdose (aOR = 2.40, 95% CI = 1.11-5.17) were most strongly associated with postpartum overdose. After stratifying by OUD status, infant diagnosis of NAS (OUD
Identifiants
pubmed: 31692133
doi: 10.1111/add.14825
pmc: PMC7066531
mid: NIHMS1562232
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
291-301Subventions
Organisme : NIDA NIH HHS
ID : K12 DA043490
Pays : United States
Organisme : NIDA NIH HHS
ID : K23 DA048169
Pays : United States
Organisme : NIDA NIH HHS
ID : K24 DA030443
Pays : United States
Organisme : NIDA NIH HHS
ID : K12 DA000357
Pays : United States
Organisme : OSTLTS CDC HHS
ID : U38 OT000143
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK105989
Pays : United States
Organisme : CDC HHS
ID : 1U38OT000143-04
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2019 Society for the Study of Addiction.
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