Jessica Frankeberger , Robert W.S. Coulter , Marian Jarlenski , Elizabeth E. Krans , Christina Mair
{"title":"Co-occurring conditions during pregnancy and hospitalizations in the first year postpartum among persons with opioid use disorder","authors":"Jessica Frankeberger , Robert W.S. Coulter , Marian Jarlenski , Elizabeth E. Krans , Christina Mair","doi":"10.1016/j.ypmed.2024.108057","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnant persons with opioid use disorder (OUD) face a multitude of comorbid conditions that may increase the risk of adverse drug and health outcomes. This study characterizes typologies of comorbidities among pregnant persons with OUD and assesses the associations of these typologies with hospitalizations in the first year postpartum.</p></div><div><h3>Methods</h3><p>A cohort of pregnant persons with OUD at delivery in 2018 were identified in a Pennsylvania statewide hospital dataset (<em>n</em> = 2055). Latent class analysis assessed 12 comorbid conditions including substance use disorders (SUDs), mental health conditions, and infections. Multivariable logistic regressions examined the association between comorbidity classes and hospitalizations (all-cause, OUD-specific, SUD-related, mental health-related) during early (0–42 days) and late (43–365 days) postpartum.</p></div><div><h3>Results</h3><p>A three-class model best fit the data. Classes included <em>low comorbidities</em> (56.9% of sample; low prevalence of co-occurring conditions), <em>moderate polysubstance/depression</em> (18.4%; some SUDs, all with depression), and <em>high polysubstance/bipolar disorder</em> (24.7%; highest probabilities of SUDs and bipolar disorder). Overall, 14% had at least one postpartum hospitalization. From 0 to 42 days postpartum, the moderate polysubstance/depression and high polysubstance/bipolar disorder classes had higher odds of all-cause and mental health-related hospitalization, compared to the low comorbidities class. From 43 to 365 days postpartum, the high polysubstance/bipolar disorder class had higher odds of all-cause hospitalizations, while both the high polysubstance/depression and moderate polysubstance/bipolar disorder classes had higher odds of SUD-related and mental health-related hospitalizations compared to the low comorbidities class.</p></div><div><h3>Conclusions</h3><p>Findings highlight the need for long-term, multidisciplinary healthcare delivery interventions to address comorbidities and prevent adverse postpartum outcomes.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Preventive medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0091743524002123","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Pregnant persons with opioid use disorder (OUD) face a multitude of comorbid conditions that may increase the risk of adverse drug and health outcomes. This study characterizes typologies of comorbidities among pregnant persons with OUD and assesses the associations of these typologies with hospitalizations in the first year postpartum.
Methods
A cohort of pregnant persons with OUD at delivery in 2018 were identified in a Pennsylvania statewide hospital dataset (n = 2055). Latent class analysis assessed 12 comorbid conditions including substance use disorders (SUDs), mental health conditions, and infections. Multivariable logistic regressions examined the association between comorbidity classes and hospitalizations (all-cause, OUD-specific, SUD-related, mental health-related) during early (0–42 days) and late (43–365 days) postpartum.
Results
A three-class model best fit the data. Classes included low comorbidities (56.9% of sample; low prevalence of co-occurring conditions), moderate polysubstance/depression (18.4%; some SUDs, all with depression), and high polysubstance/bipolar disorder (24.7%; highest probabilities of SUDs and bipolar disorder). Overall, 14% had at least one postpartum hospitalization. From 0 to 42 days postpartum, the moderate polysubstance/depression and high polysubstance/bipolar disorder classes had higher odds of all-cause and mental health-related hospitalization, compared to the low comorbidities class. From 43 to 365 days postpartum, the high polysubstance/bipolar disorder class had higher odds of all-cause hospitalizations, while both the high polysubstance/depression and moderate polysubstance/bipolar disorder classes had higher odds of SUD-related and mental health-related hospitalizations compared to the low comorbidities class.
Conclusions
Findings highlight the need for long-term, multidisciplinary healthcare delivery interventions to address comorbidities and prevent adverse postpartum outcomes.
期刊介绍:
Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.