학술논문

Opioid-Related Disorders Among Pregnant Women with Sickle Cell Disease and Adverse Pregnancy Outcomes.
Document Type
Article
Source
Pain Medicine. Nov2020, Vol. 21 Issue 11, p3087-3093. 7p.
Subject
*FETAL growth retardation
*RISK factors in premature labor
*SUBSTANCE abuse risk factors
*ANALGESICS
*MEDICAL records
*NARCOTICS
*RISK assessment
*SEPSIS
*SICKLE cell anemia
*SUBSTANCE abuse
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*ACQUISITION of data methodology
*DISEASE risk factors
*PREGNANCY
RISK factors
Language
ISSN
1526-2375
Abstract
Objective Opioid use during pregnancy has increased in recent years, parallel with the opioid epidemic in the general population. Opioids are commonly used as an analgesic for pain crisis, a hallmark symptom of sickle cell disease (SCD). With the amplified frequency and severity of SCD pain crisis during pregnancy, the use of opioids may increase concurrently. The aim of this study was to examine trends in opioid-related disorders (ORDs) among pregnant women with and without SCD, as well as assess the risk for preterm labor, maternal sepsis, and poor fetal growth among patients with SCD and ORD. Methods We conducted a retrospective analysis of inpatient pregnancy- and childbirth-related hospital discharge data from the 2002–2014 National (Nationwide) Inpatient Sample database. The primary outcome was the risk of ORD in pregnant women with SCD and its impact on threatened preterm labor, fetal growth, and maternal sepsis. Results Among the >57 million pregnancy-related hospitalizations examined, 9.6 per 10,000 had SCD. ORD in mothers with SCD was four times as prevalent as in those without SCD (2% vs 0.5%). A significant rise in ORD occurred throughout the study period and was associated with an increased risk of maternal sepsis, threatened preterm labor, and poor fetal growth. Conclusions Pregnant women with SCD have a fourfold increased risk of ORD compared with their non-SCD counterparts. The current opioid epidemic continues to worsen in both groups, warranting a tailored and effective public health response to reduce the resulting adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]