{
    "abstract": "Pregnant women with a substance-related diagnosis, such as an alcohol use disorder, are a vulnerable population that may experience higher rates of severe maternal morbidity, such as hemorrhage and eclampsia, than pregnant women with no substance-related diagnosis.\nThis retrospective cross-sectional study reviewed electronic health record data on women (aged 18-44\u00a0years) who delivered a single live birth or stillbirth at \u2265 20\u00a0weeks of gestation from March 1, 2016, to August 30, 2019. Women with and without a substance-related diagnosis were matched on key demographic characteristics, such as age, at a 1:1 ratio. Adjusting for these covariates, odds ratios and 95% confidence intervals were calculated.\nA total of 10,125 deliveries met the eligibility criteria for this study. In the matched cohort of 1,346 deliveries, 673 (50.0%) had a substance-related diagnosis, and 94 (7.0%) had severe maternal morbidity. The most common indicators in women with a substance-related diagnosis included hysterectomy (17.7%), eclampsia (15.8%), air and thrombotic embolism (11.1%), and conversion of cardiac rhythm (11.1%). Having a substance-related diagnosis was associated with severe maternal morbidity (adjusted odds ratio\u00a0=\u00a01.81 [95% CI, 1.14-2.88], p-value\u00a0=\u00a00.0126). In the independent matched cohorts by substance type, an alcohol-related diagnosis was significantly associated with severe maternal morbidity (adjusted odds ratio\u00a0=\u00a03.07 [95% CI, 1.58-5.95], p-value\u00a0=\u00a00.0009), while the patterns for stimulant- and nicotine-related diagnoses were not as well resolved with severe maternal morbidity and opioid- and cannabis-related diagnoses were not associated with severe maternal morbidity.\nWe found that an alcohol-related diagnosis, although lowest in prevalence of the substance-related diagnoses, had the highest odds of severe maternal morbidity of any substance-related diagnosis assessed in this study. These findings reinforce the need to identify alcohol-related diagnoses in pregnant women early to minimize potential harm through intervention and treatment.",
    "authors": [
        {
            "affiliation": "Department of Psychiatry, University of California San Diego, La Jolla, California, USA.",
            "firstname": "Natasia S",
            "initials": "NS",
            "lastname": "Courchesne"
        },
        {
            "affiliation": "Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, USA.",
            "firstname": "Laramie R",
            "initials": "LR",
            "lastname": "Smith"
        },
        {
            "affiliation": "School of Social Work, College of Health and Human Services, San Diego State University, San Diego, California, USA.",
            "firstname": "Mar\u00eda Luisa",
            "initials": "ML",
            "lastname": "Z\u00fa\u00f1iga"
        },
        {
            "affiliation": "Departments of Pediatrics and Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA.",
            "firstname": "Christina D",
            "initials": "CD",
            "lastname": "Chambers"
        },
        {
            "affiliation": "School of Social Work, College of Health and Human Services, San Diego State University, San Diego, California, USA.",
            "firstname": "Mark B",
            "initials": "MB",
            "lastname": "Reed"
        },
        {
            "affiliation": "Obstetrics and Gynecology, University of California San Diego, La Jolla, California, USA.",
            "firstname": "Jerasimos",
            "initials": "J",
            "lastname": "Ballas"
        },
        {
            "affiliation": "Department of Psychiatry, University of California San Diego, La Jolla, California, USA.",
            "firstname": "Carla B",
            "initials": "CB",
            "lastname": "Marienfeld"
        }
    ],
    "conclusions": "We found that an alcohol-related diagnosis, although lowest in prevalence of the substance-related diagnoses, had the highest odds of severe maternal morbidity of any substance-related diagnosis assessed in this study. These findings reinforce the need to identify alcohol-related diagnoses in pregnant women early to minimize potential harm through intervention and treatment.",
    "copyrights": "\u00a9 2021 by the Research Society on Alcoholism.",
    "doi": "10.1111/acer.14671\n10.2105/AJPH.2018.304771\n10.10.1097/AOG.0b013e31821e5f65\n10.10.1542/peds.2012-3931\n10.10.1371/journal.pmed.1001885\n10.10.1016/J.AJOG.2019.01.005\n10.10.1097/AOG.0B013E3181A81CDD\n10.10.1097/AOG.0b013e3182a06f4e\n10.10.1111/acer.13022\n10.10.1001/jama.2019.8734\n10.10.1007/978-3-030-33404-8_16\n10.10.1089/jwh.2013.4617\n10.10.3389/fpsyg.2020.00815\n10.10.1007/s11936-019-0777-5\n10.10.1097/CHI.0b013e3181bfa8ee\n10.10.1016/j.ypmed.2013.02.015\n10.10.1016/J.AJOG.2010.11.013\n10.10.1186/s12884-017-1507-1\n10.10.1016/J.ANNEPIDEM.2010.02.006\n10.10.1007/s10995-011-0898-2\n10.10.1053/J.SEMPERI.2017.07.007\n10.10.1093/pan/mpl013\n10.10.1111/j.1360-0443.2011.03613.x\n10.10.1016/J.REPROTOX.2009.04.010\n10.10.1093/pan/mpr013\n10.10.1016/J.DRUGALCDEP.2020.108236\n10.10.1001/jamapsychiatry.2019.1965\n10.10.1111/1471-0528.15818\n10.10.1097/ADM.0000000000000128\n10.10.1016/J.PRRV.2016.08.005\n10.10.1016/j.ajog.2017.05.050\n10.10.1016/J.AJOG.2015.05.025\n10.1016/j.drugalcdep.2021.108706\n10.10.1016/j.drugalcdep.2019.107817\n10.10.1055/s-0038-1667291\n10.10.1152/ajpheart.00127.2012\n10.10.1097/AOG.0b013e31824265c7\n10.10.1097/GRF.0000000000000418\n10.10.1111/j.1600-0412.2010.01030.x\n10.10.1080/00016340903214940\n10.10.1001/jamasurg.2019.2899",
    "journal": "Alcoholism, clinical and experimental research",
    "keywords": [
        "alcohol use",
        "hemorrhage",
        "pregnancy",
        "severe maternal morbidity",
        "substance-related diagnosis"
    ],
    "methods": null,
    "publication_date": "2021-08-04",
    "pubmed_id": "34341999\n30496001\n21646928\n23439891\n26440803\n30633920\n19546767\n23090519\n23921870\n27038593\n31211826\n24383493\n32477212\n31754867\n19858757\n23454595\n21257143\n28915802\n20538195\n22009444\n28823579\n21831178\n19394419\n32846369\n31389991\n31100201\n25974378\n27639458\n28578174\n25986032\n33901753\n0\n31887605\n30064145\n22730388\n22270275\n30601144\n21241259\n19707898\n31553423\n15496968",
    "results": "A total of 10,125 deliveries met the eligibility criteria for this study. In the matched cohort of 1,346 deliveries, 673 (50.0%) had a substance-related diagnosis, and 94 (7.0%) had severe maternal morbidity. The most common indicators in women with a substance-related diagnosis included hysterectomy (17.7%), eclampsia (15.8%), air and thrombotic embolism (11.1%), and conversion of cardiac rhythm (11.1%). Having a substance-related diagnosis was associated with severe maternal morbidity (adjusted odds ratio\u00a0=\u00a01.81 [95% CI, 1.14-2.88], p-value\u00a0=\u00a00.0126). In the independent matched cohorts by substance type, an alcohol-related diagnosis was significantly associated with severe maternal morbidity (adjusted odds ratio\u00a0=\u00a03.07 [95% CI, 1.58-5.95], p-value\u00a0=\u00a00.0009), while the patterns for stimulant- and nicotine-related diagnoses were not as well resolved with severe maternal morbidity and opioid- and cannabis-related diagnoses were not associated with severe maternal morbidity.",
    "title": "Association of alcohol and other substance-related diagnoses with severe maternal morbidity.",
    "xml": "<Element 'PubmedArticle' at 0x7885047609a0>"
}