학술논문
Substance-related diagnosis type predicts the likelihood and co-occurrence of preterm and cesarean delivery.
Document Type
Academic Journal
Author
Courchesne-Krak NS; Department of Psychiatry, University of California, San Diego La Jolla, CA, USA.; Zúñiga ML; School of Social Work, College of Health and Human Services, San Diego State University, San Diego, CA, USA.; Chambers C; Department of Pediatrics, Department of Family and Preventive Medicine, Division of Epidemiology, University of California San Diego, La Jolla, CA, USA.; Reed MB; School of Social Work, College of Health and Human Services, San Diego State University, San Diego, CA, USA.; Smith LR; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA.; Ballas J; Department of Obstetrics and Gynecology, University of California San Diego, La Jolla, CA, USA.; Marienfeld C; Department of Psychiatry, University of California, San Diego La Jolla, CA, USA.
Source
Publisher: Informa Healthcare Country of Publication: England NLM ID: 9107051 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-0848 (Electronic) Linking ISSN: 10550887 NLM ISO Abbreviation: J Addict Dis Subsets: MEDLINE
Subject
Language
English
Abstract
This article aimed to evaluate whether a substance-related diagnosis (SRD; i.e., alcohol, opioids, cannabis, stimulants, nicotine) predicts the likelihood and co-occurrence of preterm (20-37 weeks' gestation) and cesarean delivery.
This study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live or stillbirth at ≥ 20 weeks of gestation from 2012 to 2019. Women with and without an SRD were matched on key demographic characteristics at a 1:1 ratio. Adjusting for covariates, odds ratios and 95% confidence intervals were calculated.
Of the 19,346 deliveries, a matched cohort of 2,158 deliveries was identified. Of these, 1,079 (50%) had an SRD, 280 (13%) had a preterm delivery, 833 (39%) had a cesarean delivery, and 166 (8%) had a co-occurring preterm and cesarean delivery. An SRD was significantly associated with preterm and cesarean delivery (AOR = 1.84 [95% CI, 1.41-2.39], p -value= <0.0001; AOR = 1.51 [95% CI, 1.23-1.85], p -value= <0.0001). An alcohol-related diagnosis (AOR = 1.82 [95% CI, 1.01-3.28], p -value= 0.0471), opioid-related diagnosis (AOR = 1.94 [95% CI, 1.26-2.98], p -value= 0.0027), stimulant-related diagnosis (AOR = 1.65 [95% CI, 1.11-2.45], p -value= 0.0142), and nicotine-related diagnosis (AOR = 1.54 [95% CI, 1.05-2.26], p -value= 0.0278) were associated with co-occurring preterm and cesarean delivery.
Pregnant women with an SRD experienced disproportionally higher odds of preterm and cesarean delivery compared to pregnant women without an SRD. Substance-type predicts the type of delivery outcome. An SRD in pregnant women should be identified early to reduce potential harm through intervention and treatment.
This study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live or stillbirth at ≥ 20 weeks of gestation from 2012 to 2019. Women with and without an SRD were matched on key demographic characteristics at a 1:1 ratio. Adjusting for covariates, odds ratios and 95% confidence intervals were calculated.
Of the 19,346 deliveries, a matched cohort of 2,158 deliveries was identified. Of these, 1,079 (50%) had an SRD, 280 (13%) had a preterm delivery, 833 (39%) had a cesarean delivery, and 166 (8%) had a co-occurring preterm and cesarean delivery. An SRD was significantly associated with preterm and cesarean delivery (AOR = 1.84 [95% CI, 1.41-2.39], p -value= <0.0001; AOR = 1.51 [95% CI, 1.23-1.85], p -value= <0.0001). An alcohol-related diagnosis (AOR = 1.82 [95% CI, 1.01-3.28], p -value= 0.0471), opioid-related diagnosis (AOR = 1.94 [95% CI, 1.26-2.98], p -value= 0.0027), stimulant-related diagnosis (AOR = 1.65 [95% CI, 1.11-2.45], p -value= 0.0142), and nicotine-related diagnosis (AOR = 1.54 [95% CI, 1.05-2.26], p -value= 0.0278) were associated with co-occurring preterm and cesarean delivery.
Pregnant women with an SRD experienced disproportionally higher odds of preterm and cesarean delivery compared to pregnant women without an SRD. Substance-type predicts the type of delivery outcome. An SRD in pregnant women should be identified early to reduce potential harm through intervention and treatment.