Comparing maternal substance use and perinatal outcomes before and during the COVID-19 pandemic

Lien, Joan; Hayes, Tristan; Liu‐Smith, Feng; Rana, Divya

doi:10.1038/s41372-023-01613-8

Cited by 9 publications

(4 citation statements)

References 46 publications

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“…24 The onset of the COVID-19 pandemic has coincided with an increasingly toxic drug supply in BC, thereby accelerating the harms of the overdose crisis and potentially contributing to downstream events such as adverse pregnancy outcomes. 25 However, the relationship between preterm birth, substance use, and the impact of the pandemic is not clearly delineated in this current analysis. Further studies with larger sample sizes may be better equipped to clarify the combined effects of substance use and preterm birth during the pandemic.…”

Section: Discussionmentioning

confidence: 90%

Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia

Fu,

McClymont,

Av-Gay

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: For pregnant women living with HIV (WLWH), engagement in care is crucial to maternal health and reducing the risk of perinatal transmission. To date, there have been no studies in Canada examining the impact of the COVID-19 pandemic on pregnant WLWH. Methods: This was a retrospective cohort study assessing the impact of the pandemic on perinatal outcomes for pregnant WLWH using data from the Perinatal HIV Surveillance Program in British Columbia, Canada. We compared maternal characteristics, pregnancy outcomes, and clinical indicators related to engagement with care between a prepandemic (January 2017–March 2020) and pandemic cohort (March 2020–December 2022). We investigated preterm birth rates with explanatory variables using logistic regression analysis. Results: The prepandemic cohort (n = 87) had a significantly (P < 0.05) lower gestational age at the first antenatal encounter (9.0 vs 11.8) and lower rates of preterm births compared with the pandemic cohort (n = 56; 15% vs 37%). Adjusted odds of preterm birth increased with the presence of substance use in pregnancy (aOR = 10.45, 95% confidence interval: 2.19 to 49.94) in WLWH. There were 2 cases of perinatal transmission of HIV in the pandemic cohort, whereas the prepandemic cohort had none. Conclusions: The pandemic had pronounced effects on pregnant WLWH and their infants in British Columbia including higher rates of preterm birth and higher gestational age at the first antenatal encounter. The nonstatistically significant increase in perinatal transmission rates is of high clinical importance.

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Section: Discussionmentioning

confidence: 90%

Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia

Fu,

McClymont,

Av-Gay

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

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“…Between 2017 and 2020, 1249 pregnancy-associated deaths, most occurring in the late postpartum period, were overdose-related (Bruzelius & Martins, 2022 ). Rising rates of overdose deaths, fueled by the COVID-19 pandemic, have exacerbated concerns about perinatal SUD (Lien et al, 2023 ; Spencer et al, 2022 ; United States Government Accountability Office, 2022 ). Now is a critical time to invest in the health and wellness of perinatal people with SUD and their families.…”

mentioning

confidence: 99%

Public Health Approaches to Perinatal Substance Use: An Overview of Strategic Directions

Echols,

Collins,

Akbarali

et al. 2023

Matern Child Health J

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“…The incidence of neonatal abstinence syndrome (NAS) also increased in BC from 2.6 per 1,000 live births in 2010–2011 to 4.8 per 1,000 live births in 2019–2020 ( 7 ). Simultaneously, there has been a substantial increase in the incidence of NAS reported in the USA, England, Canada, and Western Australia in the past decade ( 8 – 10 ), and some reports suggest a continuation of high rates during the first year of the pandemic ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Neonatal abstinence syndrome and infant mortality and morbidity: a population-based study

Lisonkova,

Wen,

Richter

et al. 2024

Front. Pediatr.

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BackgroundInfant health among newborns with neonatal abstinence syndrome (NAS) has been understudied. We examined infant mortality and hospitalizations among infants diagnosed with NAS after birth.MethodsAll live births in British Columbia (BC), Canada, for fiscal years from 2004–2005 to 2019–2020, were included (N = 696,900). NAS was identified based on International Classification of Diseases, version 10, Canadian modification (ICD-10-CA) codes; the outcomes included infant death and hospitalizations during the first year of life, ascertained from BC linked administrative data. Generalized estimating equation models were used to adjust for maternal factors.ResultsThere were 2,439 infants with NAS (3.50 per 1,000 live births). Unadjusted for other factors, infant mortality was 2.5-fold higher in infants with vs. without NAS (7.79 vs. 3.08 per 1,000 live births, respectively) due to increased post-discharge mortality NAS (5.76 vs. 1.34 per 1,000 surviving infants, respectively). These differences diminished after adjustment: adjusted odds ratio (AOR) for infant death was 0.85 [95% confidence interval (CI): 0.52–1.39]; AOR for post-discharge death was 1.75 (95% CI 1.00–3.06). Overall, 22.3% infants with NAS had at least one hospitalization after post-neonatal discharge, this proportion was 10.7% in those without NAS. During the study period, discharge to foster care declined from 49.5% to 20.3% in infants with NAS.ConclusionUnadjusted for other factors, infants with NAS had increased post-discharge infant mortality and hospitalizations during the first year of life. This association diminished after adjustment for adverse maternal and socio-medical conditions. Infants with NAS had a disproportionately higher rate of placement in foster care after birth, although this proportion declined dramatically between 2004/2005 and 2019/2020. These results highlight the importance of implementing integrated care services to support infants born with NAS and their mothers during the first year of life and beyond, even though NAS itself is not independently associated with increased infant mortality.

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Comparing maternal substance use and perinatal outcomes before and during the COVID-19 pandemic

Cited by 9 publications

References 46 publications

Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia

Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia

Public Health Approaches to Perinatal Substance Use: An Overview of Strategic Directions

Neonatal abstinence syndrome and infant mortality and morbidity: a population-based study

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