ホームIMICライブラリMMWR抄訳2020年(Vol.69)バイタルサイン:妊娠中の処方オピオイド鎮痛薬の使用・・・
MMWR抄訳
2020/07/17Vol. 69 / No. 28
MMWR69(28):897-903
Vital Signs: Prescription Opioid Pain Reliever Use During Pregnancy — 34 U.S. Jurisdictions, 2019
バイタルサイン:妊娠中の処方オピオイド鎮痛薬の使用 ― 34のアメリカ管轄地域、2019年
妊娠中のオピオイドの使用は胎児の転帰不良(新生児オピオイド離脱症候群、早産、胎児成長不良、死産など)と関連する。今回、CDCはPregnancy Risk Assessment Monitoring System(PRAMS)の調査にて32管轄地域(30州、ワシントンDC、プエルトリコ)における2019年データとPRAMSに参加していない2つの管轄地域(カリフォルニア州、オハイオ州)において2019年に行われた母体および新生児の健康調査の結果を使用して、妊娠中に使用された処方オピオイド鎮痛薬について分析した。2019年、回答者21,488名のうち、20,643名(96.1%)が最近の妊娠時における処方オピオイドの使用状況について回答し、1,405名(6.6%)が妊娠中に処方オピオイドを使用していた。妊娠中の処方オピオイドの使用に年齢、人種/民族、学歴などによる相違は認めず、加入している医療保険(民間保険の加入者:5.2%、Medicaid:8.5%、その他/非加入:4.4%)、妊娠中の直近3カ月間の喫煙の有無(喫煙者:16.2%、非喫煙者:5.9%)、妊娠中のうつ症状の有無(あり:13.1%、なし:5.4%)による有意差を認めた。オピオイドの入手先は医療従事者が91.3%、医療従事者以外(友人、家族など)が8.9%、その他/不明が4.3%であり、オピオイドの使用理由は疼痛が88.8%、疼痛以外の理由が14.4%、その他/不明が4.9%であった。全体で21.2%が処方オピオイドを誤用しており(医療従事者以外から入手、疼痛以外の理由で使用)、27.1%が減量または使用中止を希望または必要としていた。また、オピオイド使用が新生児へ及ぼす影響について医療従事者から助言があったのは68.1%であった。以上、妊娠中に処方オピオイドを使用しれた妊婦の約1/5が誤用していることから、妊婦におけるオピオイド誤用のスクリーニングとオピオイド使用障害の治療について改善することにより、有害転帰を予防できるかもしれない。
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