The association between use of opiates, cocaine, and amphetamines during pregnancy and maternal postpartum readmission in the United States: A retrospective analysis of the Nationwide Readmissions Database
| Autor: | Syed Ahsan Raza, Jason L. Salemi, Jo Anna R. Fields-Gilmore, Maria C. Mejia de Grubb, Sanjukta Modak, Roger Zoorob |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Databases Factual Toxicology Logistic regression computer.software_genre Patient Readmission Odds 03 medical and health sciences Young Adult 0302 clinical medicine Cocaine Pregnancy Risk Factors Health care medicine Humans Pharmacology (medical) 030212 general & internal medicine Retrospective Studies Pharmacology Database business.industry Public health Opiate Alkaloids Stressor Amphetamines Postpartum Period Odds ratio Middle Aged medicine.disease Patient Discharge United States Pregnancy Complications Psychiatry and Mental health Female Diagnosis code business computer 030217 neurology & neurosurgery |
| Zdroj: | Drug and alcohol dependence. 210 |
| ISSN: | 1879-0046 |
| Popis: | Background Substance use during pregnancy has increased in the United States, with adverse consequences for mother and baby. Similarly, postpartum readmission (PPR) imposes physical, emotional, and financial stressors causing disruption to family functioning and childcare. We used national data to estimate the extent to which women who used opiates, cocaine, and amphetamines during pregnancy are at increased risk of PPR. Methods We analyzed 2010–2014 data from the Nationwide Readmissions Database (NRD). Our exposure, drug use during pregnancy, was identified using diagnosis codes indicative of opioid, cocaine or amphetamine use, abuse, or dependence. The outcome was all-cause PPR, maternal readmission within 42 days following discharge from the delivery hospitalization. Multivariable logistic regression was used to estimate odds ratios (OR) that represented associations between drug use and PPR. Results Among 11 million delivery hospitalizations, nearly 1 % had documented use of opiates, cocaine and/or amphetamines. The crude PPR rate was nearly four times higher among users (54.6 per 1000) compared to non-users (14.0 per 1000), and 1 in 10 women who had documented use of more than one drug category experienced postpartum readmission. Even after controlling for sociodemographic and clinical confounders, we observed a two-fold increased odds of PPR among users compared to non-users (OR = 1.95; 95 % CI: 1.82, 2.07). Conclusions The national opioid epidemic should encourage a paradigm shift in health care public policy to facilitate the management of all substance use disorders as chronic medical conditions through evidence-based public health initiatives to prevent these disorders, treat them, and promote recovery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect