Well-Child Care Adherence After Intrauterine Opioid Exposure
| Autor: | Diane J. Abatemarco, Stephen W. Patrick, Jessica F. Rohde, Neera K. Goyal, Esther K. Chung, Vanessa L. Short |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Databases Factual Child Health Services Population Appointments and Schedules 03 medical and health sciences 0302 clinical medicine Pregnancy Interquartile range 030225 pediatrics Outcome Assessment Health Care Health care Humans Medicine education Retrospective Studies education.field_of_study business.industry Child Health Absolute risk reduction Infant Retrospective cohort study Articles Opioid-Related Disorders medicine.disease Prenatal Exposure Delayed Effects Pediatrics Perinatology and Child Health Patient Compliance Regression Analysis Female Diagnosis code business Psychosocial |
| Zdroj: | Pediatrics |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2019-1275 |
| Popis: | BACKGROUND AND OBJECTIVES: For children with intrauterine opioid exposure (IOE), well-child care (WCC) provides an important opportunity to address medical, developmental, and psychosocial needs. We evaluated WCC adherence for this population. METHODS: In this retrospective cohort study, we used PEDSnet data from a pediatric primary care network spanning 3 states from 2011 to 2016. IOE was ascertained by using physician diagnosis codes. WCC adherence in the first year was defined as a postnatal or 1-month visit and completed 2-, 4-, 6-, 9-, and 12-month visits. WCC adherence in the second year was defined as completed 15- and 18-month visits. Gaps in WCC, defined as ≥2 missed consecutive WCC visits, were also evaluated. We used multivariable regression to test the independent effect of IOE status. RESULTS: Among 11 334 children, 236 (2.1%) had a diagnosis of IOE. Children with IOE had a median of 6 WCC visits (interquartile range 5–7), vs 8 (interquartile range 6–8) among children who were not exposed (P < .001). IOE was associated with decreased WCC adherence over the first and second years of life (adjusted relative risk 0.54 [P < .001] and 0.74 [P < .001]). WCC gaps were more likely in this population (adjusted relative risk 1.43; P < .001). There were no significant adjusted differences in nonroutine primary care visits, immunizations by age 2, or lead screening. CONCLUSIONS: Children |
| Databáze: | OpenAIRE |
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