在分娩时发生严重孕产妇发病风险 患有阿片类药物使用障碍的人
Godwin K Osei-Poku1, Julia C Prentice2, Mary Peeler3
1Betsy Lehman Center for Patient Safety, Commonwealth of Massachusetts, Boston, Massachusetts.
概括
患有阿片类药物使用障碍 (OUD) 的人面临更高的严重孕产妇发病率 (SMM) 风险. 在分娩中解决OUD对于改善孕产妇健康结果和减少差异至关重要.
科学领域:
- 生殖健康 生殖健康
- 孕产妇健康 孕产妇健康
- 药物使用障碍 药物使用障碍
背景情况:
- 阿片类药物使用障碍 (OUD) 是对母亲健康日益关注的问题.
- 严重的孕产妇发病率 (SMM) 影响着分娩的个体,基于种族和种族的潜在差异.
研究的目的:
- 检查患有阿片类药物使用障碍 (OUD) 的分娩个体中严重的孕产妇死亡率 (SMM).
- 评估OUD的分娩个体中SMM的种族和民族差异.
主要方法:
- 使用马萨诸塞州医院出院数据 (2016-2020) 的回顾性队列研究.
- 对于有或没有OUD的个人来说,计算的SMM率.
- 使用多变量后勤回归来分析OUD,种族/种族和SMM之间的关联.
主要成果:
- 与没有OUD的人 (88/10,000) 相比,患有OUD的人的SMM率更高 (148/10,000).
- OUD与SMM的概率增加了2.12倍.
- 与非西班牙裔白人相比,非西班牙裔黑人和西班牙裔人的SMM几率更高.
结论:
- 有OUD的分娩个体具有SMM的风险较高.
- 改善获得OUD治疗和支持的机会至关重要.
- 围产质量倡议应专注于OUD患者的SMM.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
346
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
346
Opioid Analgesics: Morphine and Other Natural Cogeners
300
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
300
Analgesia and Pain Management
665
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
665
Local Anesthetics: Clinical Application as Epidural Anesthesia
458
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
458
Opioid Receptors: Overview
1.1K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
1.1K
Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
351
Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
351


