Abstract:
OBJECTIVE:To estimate fatal and nonfatal opioid overdose events in pregnant and postpartum women in Massachusetts, comparing rates in individuals receiving and not receiving pharmacotherapy for opioid use disorder (OUD). METHODS:We conducted a population-based retrospective cohort study using linked administrative and vital statistics databases in Massachusetts to identify women with evidence of OUD who delivered a liveborn neonate in 2012-2014. We described maternal sociodemographic, medical, and substance use characteristics, computed rates of opioid overdose events in the year before and after delivery, and compared overdose rates by receipt of pharmacotherapy with methadone or buprenorphine in the prenatal and postpartum periods. RESULTS:Among 177,876 unique deliveries, 4,154 (2.3%) were to women with evidence of OUD in the year before delivery, who experienced 242 total opioid-related overdose events (231 nonfatal, 11 fatal) in the year before or after delivery. The overall overdose rate was 8.0 per 100,000 person-days. Overdoses were lowest in the third trimester (3.3/100,000 person-days in the third trimester) and then increased in the postpartum period with the highest overdose rate 7-12 months after delivery (12.3/100,000 person-days). Overall, 64.3% of women with evidence of OUD in the year before delivery received any pharmacotherapy in the year before delivery. Women receiving pharmacotherapy had reduced overdose rates in the early postpartum period. CONCLUSION:Pregnant women in Massachusetts have high rates of OUD. The year after delivery is a vulnerable period for women with OUD. Additional longitudinal supports and interventions tailored to women in the first year postpartum are needed to prevent and reduce overdose events.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Schiff DM,Nielsen T,Terplan M,Hood M,Bernson D,Diop H,Bharel M,Wilens TE,LaRochelle M,Walley AY,Land Tdoi
10.1097/AOG.0000000000002734subject
Has Abstractpub_date
2018-08-01 00:00:00pages
466-474issue
2eissn
0029-7844issn
1873-233Xjournal_volume
132pub_type
杂志文章abstract:OBJECTIVE:To examine recurrent preterm birth and early term birth in women's initial and immediately subsequent pregnancies. METHODS:This retrospective cohort study included 163,889 women who delivered their first and second liveborn singleton neonates between 20 and 44 weeks of gestation in California from 2005 throu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001506
更新日期:2016-08-01 00:00:00
abstract::An increase in cocaine abuse by pregnant women has been associated with a range of maternal/fetal cardiovascular complications. Intracerebral hemorrhage has been reported as a cocaine-related complication, but has not previously been associated with pregnancy. We report a case of cocaine-associated intracerebral hemor...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:To study the efficacy, safety, and acceptability of oral immediately swallowed and buccal misoprostol 800 mcg after mifepristone 200 mg for terminating pregnancy through 63 days since the last menstrual period (LMP). METHODS:This seven-site study randomly assigned 966 women seeking abortions to oral or bucca...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AOG.0b013e31818d8eb4
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To determine factors possibly associated with reduced bone density in women using the injectable contraceptive depot medroxyprogesterone acetate. METHODS:In a cross-sectional study, bone mineral density of the lumbar spine was measured by dual energy x-ray absorptiometry in 200 current users of depot medroxy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00270-1
更新日期:1998-10-01 00:00:00
abstract::Advances within the medical profession have resulted in an increase in available medical therapeutic options and minimally invasive surgical techniques for common gynecologic conditions. In many circumstances, this has led to a reduction in surgical volume for many common conditions in benign gynecology. There is also...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a5fde5
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To determine trends in the clinicopathology of vulvar squamous cell carcinoma over the past 2 decades, with particular reference to the possible effects of the increasing incidence of vulvar intraepithelial neoplasia (VIN) during this time. METHODS:Two cohorts of 56 and 57 women with squamous cell carcinoma ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00298-6
更新日期:1997-09-01 00:00:00
abstract::Case-control studies begin at the end. Two groups of patients, those with disease (cases) and those without (controls), are compared to determine the degree of exposure to a presumed risk factor. This research method is commonly used to study rare diseases or diseases that take years to develop. If a higher proportion...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract::Blood samples were obtained from 5 women during the menstrual cycle in which they had conceived. Although neither the women nor their physicians were clinically aware that conception had occurred, one or more of the blood specimens from each woman contained human chorionic gonadotropin (hCG), as measured by a specific...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract:OBJECTIVE:To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS:This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182917529
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Traditional methods of exchange of research information may not be rapid enough, especially for international multicenter studies or when discussing controversial issues such as the value of fetal monitoring. The Internet is a useful tool that provides numerous opportunities for immediate communication withi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00569-4
更新日期:2000-02-01 00:00:00
abstract::This review is designed to provide a broad view of fetal cardiovascular response to fetal distress. The presentation focuses on data obtained from laboratories working with fetal sheep, or occasionally fetal monkeys, instead of attempting to interpret data resulting from human fetal studies. Human fetal studies are un...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract:OBJECTIVE:To assess treatment outcomes associated with an obstetric hypertensive emergency quality improvement intervention instituted in a tertiary care women's emergency department. METHODS:We conducted a cohort study of pregnant (20 weeks of gestation or greater) and postpartum (6 weeks of gestation or less) women ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002809
更新日期:2018-10-01 00:00:00
abstract::Two cases of unusual postpartum fever in foreign nationals are presented. Prolonged work-up led to the diagnosis of pulmonary tuberculosis as a cause of postpartum fever that responded well to antituberculous drugs. The signs and symptoms illustrated by these cases should alert physicians to consider tuberculosis in t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of corpus uteri, cervix uteri, and ovarian malignancy in women undergoing hysterectomy or myomectomy for presumed benign indications. METHODS:We conducted a secondary analysis of data from the 2014-2015 American College of Surgeons National Surgical Quality Improvement Program. Adu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000002521
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To assess consistency of hospital coding for patients with cesarean delivery-related admissions. METHODS:Hospital coders from 11 participating institutions received a brief questionnaire and a standardized, inpatient record that was developed for nine hypothetical patients who delivered by cesarean delivery....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181ad9533
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To develop a model based on factors available at the first prenatal visit that predicts chance of successful vaginal birth after cesarean delivery (VBAC) for individual patients who undergo a trial of labor. METHODS:All women with one prior low transverse cesarean who underwent a trial of labor at term with ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.AOG.0000259312.36053.02
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Hyperemesis gravidarum may lead to hypovolemia and substantial electrolyte abnormalities, including hypokalemia. Hypokalemia, when profound, may result in rare consequences, such as rhabdomyolysis. CASE:A 20-year-old woman with hyperemesis gravidarum at 19 weeks of gestation presented with extreme leg weakn...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001418
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:To assess the estrogenic effect of tamoxifen and associated pathologic changes of the endometrium in postmenopausal breast cancer patients. METHODS:The endometrium of 103 gynecologically asymptomatic postmenopausal breast cancer patients was examined. Fifty-one had been treated with tamoxifen and 52 had not ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::The gonadotropin-releasing hormone agonist (GnRH-a) leuprolide acetate depot was used as a biologic probe to investigate the possible roles of insulin-like growth factors (IGFs) I and II in fibroid growth. The secretion of IGF-I and IGF-II by explant cultures of fibroids and myometria from women treated with a GnRH-a ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To compare the effect of depot medroxyprogesterone acetate (DMPA) and two types of oral contraceptives (OC) on bone mineral density (BMD) among women 18-33 years of age with those not using hormonal contraception. METHODS:Data from 155 women were analyzed. Depot medroxyprogesterone acetate was administered t...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0029-7844(01)01495-8
更新日期:2001-10-01 00:00:00
abstract::Fertility and pregnancy complications were assessed in 137 women at risk of having inherited the gene for autosomal dominant polycystic kidney disease. Seventy-six (55%) of these subjects were found to have polycystic kidney disease (multiple renal cysts). The remaining 61 women served as controls. The prevalence of f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:To present tactics for optimizing outpatient vaginal hysterectomy and describe perioperative outcomes in a large consecutive case series. METHODS:This is a descriptive study and review of clinical outcomes in 1,071 patients selected to undergo vaginal hysterectomy for benign indications from 2000 to 2010. Th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/aog.0b013e3182732ece
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the quality of logistic regression reporting in the obstetrics and gynecology literature. METHODS:All original papers published in 2005 and 2006 in four leading obstetrics and gynecology journals were manually searched for the use of logistic regression. One hundred four articles that used logist...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318160f38e
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of prolonged vaginal distention and anal sphincter transection on contractile properties of the external anal sphincter. METHODS:Young female virgin rats were randomly assigned to four treatment groups (sham, vaginal distention, transection of anal sphincter plus repair, or combined di...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318162f6a7
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of an advanced-practice nurse-obstetrician collaborative prenatal practice. METHODS:A group of 194 consecutively enrolled medically low-risk obstetric patients was identified between January 1, 1994 and December 31, 1994 at Neighborhood Pregnancy Care, a collaborative-practice s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00649-2
更新日期:1998-02-01 00:00:00
abstract::The endocrine effects of induction of ovulation with menotropins were studied in 43 patients: 11 with hypothalamic amenorrhea and 32 with the polycystic ovary syndrome. Patients with polycystic ovary syndrome had higher base-line values of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17 beta-est...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::A registry of ultrasound procedures spanning nearly 5 years was searched retrospectively to discover cases of endometrial cavity fluid collections in postmenopausal women. Twenty cases were identified; all medical records were available for review. One patient was lost to follow-up. Seventeen patients had surgical pro...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Perineal lacerations are a common occurrence with vaginal delivery. Although perineal lacerations are tracked easily from coding data, there are a variety of problems with using rates of such tears as a quality measure. The rate of severe perineal lacerations should not be used as a measure of obstetric quality for th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001146
更新日期:2015-11-01 00:00:00
abstract::A review of 25 patients with more than 1 rubella titer by hemagglutination-inhibition testing revealed 3 patients with high positive titers that were reported to be negative in subsequent pregnancies. None of the patients had received the rubella vaccine. Because the sensitivity and reliability of hemagglutination-inh...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-08-01 00:00:00
abstract::We have reviewed the family histories of children with neural tube defects to determine which relatives are at sufficient risk to be offered amniocentesis for prenatal diagnosis. The recurrence risks for sibs was 6%; therefore, women with one affected child should be made aware of the availability of this test for mon...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00