产前暴露于阿片类药物和神经发育障碍儿童:贝叶斯调解分析
American journal of epidemiology
|September 6, 2023
概括
产前阿片类药物暴露与儿童神经发育障碍 (NDD) 诊断的加快有关. 不良的怀孕和分娩结果显著调解了这一关联,特别是怀孕期间晚期暴露.
科学领域:
- 围产期流行病学 围产期流行病学
- 发育神经科学的发展神经科学.
- 公共卫生 公共卫生
背景情况:
- 产前阿片类药物暴露对儿童神经发育的潜在长期影响越来越关注.
- 了解阿片类药物暴露影响神经发育障碍 (NDD) 的途径对于干预至关重要.
研究的目的:
- 调查产前阿片类药物暴露对NDDs的自然直接和联合自然间接影响 (JNIE).
- 通过怀孕并发症,先天性形和新生儿不良结果来研究调解.
主要方法:
- 使用的医疗补助申请与罗德岛 (2008-2018) 的重要统计数据相关.
- 采用贝叶斯调解分析与弹性净收缩前和马尔科夫链蒙特卡洛算法.
- 分析了11,176例怀孕的数据,识别了那些处方阿片类药物处方的人.
主要成果:
- 在所有三个月中,在加速的NDD诊断上观察到显著的阿片类药物暴露的JNIE.
- JNIE比例为17.9% (T1),22.4% (T2) 和56.3% (T3),这表明随着后期暴露的增加中介作用.
- 在怀孕期间暴露于阿片类药物显著增加了儿童NDD诊断的风险.
结论:
- 不良的怀孕和分娩结果共同调解了产前阿片类药物暴露和加速NDD诊断之间的联系.
- 通过这些不良结果调解的比例随着阿片类药物暴露时间接近分娩而增加.
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