Categorization of Opioid Use Among Pregnant People and Association With Overdose or Death

Camden, Andi; To, Teresa; Ray, Joel G.; Gomes, Tara; Bai, Li; Guttmann, Astrid

doi:10.1001/jamanetworkopen.2022.14688

Cited by 5 publications

(5 citation statements)

References 55 publications

(115 reference statements)

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“…These rates are high in comparison to the prevalence rates from a study conducted in 2017 which showed lower rates for tobacco (14.7%), cannabis (7.1%), and alcohol use (11.5%) among pregnant women [ 22 ]. Further, opioid use during pregnancy is associated with an increased risk for postpartum drug overdose or death [ 24 ]. Depressive disorders and substance use/abuse are often comorbid and are co-occurring risk factors for each other [ 25 ]; this comorbidity yields higher risks for suicide [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use?

Howard

Leong

Chambless

et al. 2022

IJERPH

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Rates of mood disorders and substance use increased during the COVID-19 pandemic for postpartum women. The present study’s aims were to: (1) examine the prevalence of major depressive disorder (MDD) in postpartum women during the COVID-19 pandemic, and (2) evaluate whether social support can buffer the associations between MDD, psychosocial factors (perceived stress, generalized anxiety, and intimate partner violence) and substance use (alcohol and drug use). A nationwide survey included 593 postpartum mothers (within 12 months from birth). Participants were assessed for a provisional diagnosis of MDD, and provided responses on validated instruments measuring stress, intimate partner violence, suicidal ideation, generalized anxiety, social support, and substance use. A hierarchical logistic regression model assessed the association of psychosocial factors and substance use with MDD. The final model shows that social support attenuates the association of MDD with perceived stress, alcohol use, and drug use, but does not buffer the relationship of MDD with anxiety or intimate partner violence. Social support was shown to significantly attenuate the effects of stress, alcohol use, and drug use on MDD, suggesting that the presence of a strong, supportive social network should be an area of increased focus for public health and healthcare professionals when caring for postpartum women.

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Section: Introductionmentioning

confidence: 99%

Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use?

Howard

Leong

Chambless

et al. 2022

IJERPH

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“…Sensitivity analyses included (1) classifying the outcome as a developmental screening composite of physician visits for 18-month enhanced well-child visits, neurodevelopmental assessment or paediatric developmental assessment (to assess additional developmental screening); (2) classifying the exposure as NAS (to assess different follow-up care); (3) classifying the exposure according to five distinct subgroups of people who Original research used opioids in pregnancy, using a previously generated latent class analysis 33 (LCA) of 20 social, clinical and pharmacological factors (online supplemental table 4), including short-term analgesia with low comorbidity (group 1), analgesia in young people (group 2), MOUD or unregulated opioid use (group 3), pain management with comorbidity (group 4) and mixed opioid use+high social and medical needs (group 5); (4) excluding children residing in rural areas (to assess receiving well-child care from a nursing station in remote areas not captured in our data); (5) excluding children with zero well-child visits (to assess primary care not captured by our data); and (6) excluding children with birth hospitalisations of >56 days (to evaluate different care received while hospitalised).…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] weeks' gestation in Ontario, Canada, between 1 January 2014 and 28 February 2018. Ontario has a universal publicly funded healthcare system.…”

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confidence: 99%

Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study

Camden

Gomes

et al. 2023

Arch Dis Child

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ObjectivesTo quantify well-child visits by age 2 years and developmental screening at the 18-month enhanced well-child visit among children with prenatal opioid exposure (POE) and to identify factors associated with study outcomes.DesignPopulation-based cohort study.SettingOntario, Canada.Participants22 276 children with POE born 2014–2018 were classified as (1) 1–29 days of prescribed opioid analgesia, (2) 30+ days of prescribed opioid analgesia, (3) medication for opioid use disorder (MOUD), (4) MOUD and opioid analgesia, or (5) unregulated opioids.Main outcome measuresAttending ≥5 well-child visits by age 2 years and the 18-month enhanced well-child visit. Modified Poisson regression was used to examine factors associated with outcomes.ResultsChildren with POE to 1–29 days of analgesics were most likely to attend ≥5 well-child visits (61.2%). Compared with these children, adjusted relative risks (aRRs) for ≥5 well-child visits were lower among those exposed to 30+ days of opioid analgesics (0.95, 95% CI 0.91 to 0.99), MOUD (0.83, 95% CI 0.79 to 0.88), MOUD and opioid analgesics (0.78 95% CI 0.68 to 0.90) and unregulated opioids (0.89, 95% CI 0.83 to 0.95). Relative to children with POE to 1–29 days of analgesics (58.5%), respective aRRs for the 18-month enhanced well-child visit were 0.92 (95% CI 0.88 to 0.96), 0.76 (95% CI 0.72 to 0.81), 0.76 (95% CI 0.66 to 0.87) and 0.82 (95% CI 0.76 to 0.88). Having a regular primary care provider was positively associated with study outcomes; socioeconomic disadvantage, rurality and maternal mental health were negatively associated.ConclusionWell-child visits are low in children following POE, especially among offspring of mothers receiving MOUD or unregulated opioids. Strategies to improve attendance will be important for child outcomes.

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“…In the Original Investigation titled “Categorization of Opioid Use Among Pregnant People and Association With Overdose or Death,” 1 published May 27, 2022, there was an error in the text, tables, figure, and supplement. These sections should have stated that adjusted rate ratios were calculated, not adjusted relative risks.…”

mentioning

confidence: 99%

“…These sections should have stated that adjusted rate ratios were calculated, not adjusted relative risks. This article has been corrected …”

mentioning

confidence: 99%

Error in Text, Tables, Figure, and Supplement

2022

JAMA Netw Open

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Categorization of Opioid Use Among Pregnant People and Association With Overdose or Death

Cited by 5 publications

References 55 publications

Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use?

Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use?

Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study

Error in Text, Tables, Figure, and Supplement

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