Aneesha Cheedalla,Marissa Berry,Mahmoud Abdelwahab,Jamie Cowen,Alexandra Stiles,Isabelle Mason,Jonathan R Honegger,Kara Rood
{"title":"阿片类药物使用障碍孕妇的丙型肝炎病毒感染及其与早产的关系。","authors":"Aneesha Cheedalla,Marissa Berry,Mahmoud Abdelwahab,Jamie Cowen,Alexandra Stiles,Isabelle Mason,Jonathan R Honegger,Kara Rood","doi":"10.1055/a-2413-2306","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\r\nBoth hepatitis C virus (HCV) and opioid use disorder (OUD) have been associated with higher rates of preterm birth (PTB). It is unknown whether the higher prevalence of HCV in individuals with OUD may contribute to this association. The objective of this study is to evaluate the association between HCV and PTB in pregnant individuals with OUD.\r\n\r\nSTUDY DESIGN\r\nWe conducted a retrospective cohort of pregnant individuals with OUD who participated in >3 visits in a co-located multidisciplinary program. Inclusion criteria were a diagnosis of OUD, participation in treatment/prenatal care program, and laboratory evaluation of HCV status. The primary exposure was presence of HCV antibodies, and secondarily, a detectable viral load (viremia). The primary outcome was PTB, which was further classified as spontaneous or iatrogenic. Multivariable logistic regression was used to detect associations while adjusting for race, history of prior PTB, and tobacco use.\r\n\r\nRESULTS\r\nA total of 941 individuals were included in the study, 404 with HCV and 537 without. Rates of PTB did not differ between those with compared to those without HCV (20.3% vs 23.8%, aOR 0.75 [95% CI 0.53-1.07]). There were similar rates of spontaneous PTB (13.1% vs 16.2%, aOR 0.79 [95% CI 0.43-1.45]) and iatrogenic PTB (7.2% vs 7.6%, aOR 1.26 [95% CI 0.69-2.30]). Comparing those with viremia to those without, there were also similar rates of overall PTB (21.6 vs 17.9%, aOR 0.86 [95% CI 0.52-1.44]), spontaneous PTB (13.3% vs 12.9%, aOR 0.97 [95% CI 0.52-1.87]), and iatrogenic PTB (8.3 vs 5.0%, aOR 1.83 [95% CI 0.76-4.94]).\r\n\r\nCONCLUSION\r\nHCV does not appear to be associated with spontaneous or iatrogenic PTB in pregnant persons with OUD who are engaged in treatment and prenatal care. The role of co-located multidisciplinary prenatal and addiction programs in the association between HCV and PTB warrants further investigation.","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hepatitis C virus infection in pregnant individuals with opioid use disorder and its association with preterm birth.\",\"authors\":\"Aneesha Cheedalla,Marissa Berry,Mahmoud Abdelwahab,Jamie Cowen,Alexandra Stiles,Isabelle Mason,Jonathan R Honegger,Kara Rood\",\"doi\":\"10.1055/a-2413-2306\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\r\\nBoth hepatitis C virus (HCV) and opioid use disorder (OUD) have been associated with higher rates of preterm birth (PTB). It is unknown whether the higher prevalence of HCV in individuals with OUD may contribute to this association. The objective of this study is to evaluate the association between HCV and PTB in pregnant individuals with OUD.\\r\\n\\r\\nSTUDY DESIGN\\r\\nWe conducted a retrospective cohort of pregnant individuals with OUD who participated in >3 visits in a co-located multidisciplinary program. Inclusion criteria were a diagnosis of OUD, participation in treatment/prenatal care program, and laboratory evaluation of HCV status. The primary exposure was presence of HCV antibodies, and secondarily, a detectable viral load (viremia). The primary outcome was PTB, which was further classified as spontaneous or iatrogenic. Multivariable logistic regression was used to detect associations while adjusting for race, history of prior PTB, and tobacco use.\\r\\n\\r\\nRESULTS\\r\\nA total of 941 individuals were included in the study, 404 with HCV and 537 without. Rates of PTB did not differ between those with compared to those without HCV (20.3% vs 23.8%, aOR 0.75 [95% CI 0.53-1.07]). There were similar rates of spontaneous PTB (13.1% vs 16.2%, aOR 0.79 [95% CI 0.43-1.45]) and iatrogenic PTB (7.2% vs 7.6%, aOR 1.26 [95% CI 0.69-2.30]). Comparing those with viremia to those without, there were also similar rates of overall PTB (21.6 vs 17.9%, aOR 0.86 [95% CI 0.52-1.44]), spontaneous PTB (13.3% vs 12.9%, aOR 0.97 [95% CI 0.52-1.87]), and iatrogenic PTB (8.3 vs 5.0%, aOR 1.83 [95% CI 0.76-4.94]).\\r\\n\\r\\nCONCLUSION\\r\\nHCV does not appear to be associated with spontaneous or iatrogenic PTB in pregnant persons with OUD who are engaged in treatment and prenatal care. The role of co-located multidisciplinary prenatal and addiction programs in the association between HCV and PTB warrants further investigation.\",\"PeriodicalId\":7584,\"journal\":{\"name\":\"American journal of perinatology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of perinatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2413-2306\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2413-2306","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的丙型肝炎病毒(HCV)和阿片类药物使用障碍(OUD)都与较高的早产率(PTB)有关。目前尚不清楚丙型肝炎病毒(HCV)在 OUD 患者中的流行率较高是否会导致这种关联。本研究的目的是评估患有 OUD 的孕妇中 HCV 与早产率之间的关系。研究设计我们对患有 OUD 的孕妇进行了回顾性队列研究,这些孕妇参加了在同一地点开展的多学科项目中的 3 次以上就诊。纳入标准为确诊为 OUD、参与治疗/产前护理计划以及 HCV 状态实验室评估。主要暴露指标是是否存在 HCV 抗体,其次是能否检测到病毒载量(病毒血症)。主要结果是PTB,进一步分为自发性和先天性。研究采用多变量逻辑回归法检测相关性,同时对种族、既往PTB病史和吸烟情况进行调整。与未感染 HCV 的患者相比,PTB 发生率没有差异(20.3% vs 23.8%,aOR 0.75 [95% CI 0.53-1.07])。自发性 PTB(13.1% vs 16.2%,aOR 0.79 [95% CI 0.43-1.45])和先天性 PTB(7.2% vs 7.6%,aOR 1.26 [95% CI 0.69-2.30])的发生率相似。有病毒感染者与无病毒感染者相比,总体 PTB(21.6% vs 17.9%,aOR 0.86 [95% CI 0.52-1.44])、自发性 PTB(13.3% vs 12.9%,aOR 0.97 [95% CI 0.52-1.87])和先天性 PTB(8.3% vs 5.0%,aOR 1.26 [95% CI 0.69-2.30])的发生率也相似。结论在接受治疗和产前护理的 OUD 孕妇中,HCV 似乎与自发性或先天性 PTB 无关。在HCV与PTB的关系中,多学科产前和戒毒计划的共同作用值得进一步研究。
Hepatitis C virus infection in pregnant individuals with opioid use disorder and its association with preterm birth.
OBJECTIVE
Both hepatitis C virus (HCV) and opioid use disorder (OUD) have been associated with higher rates of preterm birth (PTB). It is unknown whether the higher prevalence of HCV in individuals with OUD may contribute to this association. The objective of this study is to evaluate the association between HCV and PTB in pregnant individuals with OUD.
STUDY DESIGN
We conducted a retrospective cohort of pregnant individuals with OUD who participated in >3 visits in a co-located multidisciplinary program. Inclusion criteria were a diagnosis of OUD, participation in treatment/prenatal care program, and laboratory evaluation of HCV status. The primary exposure was presence of HCV antibodies, and secondarily, a detectable viral load (viremia). The primary outcome was PTB, which was further classified as spontaneous or iatrogenic. Multivariable logistic regression was used to detect associations while adjusting for race, history of prior PTB, and tobacco use.
RESULTS
A total of 941 individuals were included in the study, 404 with HCV and 537 without. Rates of PTB did not differ between those with compared to those without HCV (20.3% vs 23.8%, aOR 0.75 [95% CI 0.53-1.07]). There were similar rates of spontaneous PTB (13.1% vs 16.2%, aOR 0.79 [95% CI 0.43-1.45]) and iatrogenic PTB (7.2% vs 7.6%, aOR 1.26 [95% CI 0.69-2.30]). Comparing those with viremia to those without, there were also similar rates of overall PTB (21.6 vs 17.9%, aOR 0.86 [95% CI 0.52-1.44]), spontaneous PTB (13.3% vs 12.9%, aOR 0.97 [95% CI 0.52-1.87]), and iatrogenic PTB (8.3 vs 5.0%, aOR 1.83 [95% CI 0.76-4.94]).
CONCLUSION
HCV does not appear to be associated with spontaneous or iatrogenic PTB in pregnant persons with OUD who are engaged in treatment and prenatal care. The role of co-located multidisciplinary prenatal and addiction programs in the association between HCV and PTB warrants further investigation.
期刊介绍:
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.