Dataset Information

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020.

ABSTRACT: Objectives: This study assesses the association between adverse childhood experiences (ACEs) and prescription opioid use during pregnancy. Methods: This study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. The relationship between ACEs and prescription opioid use during pregnancy is examined using multiple logistic regression. Results: The prevalence of prescription opioid use increases alongside accumulating ACEs. Compared to those with no ACEs, recent mothers with three or more ACEs have a 2.4 greater odds of prescription opioid use during pregnancy (aOR [adjusted odds ratio] = 2.437; 95% CI [confidence interval] = 1.319, 4.503). Conclusion: Accumulating ACEs are associated with an increased risk of prescription opioid use during pregnancy. Additional research is needed better understand the mechanisms that link ACEs and prescription opioid use during pregnancy, as well as how to best support those with ACEs exposure in a trauma-informed manner to reduce the risk of substance use.

SUBMITTER: Testa A

PROVIDER: S-EPMC10197742 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020.

Testa Alexander A Jacobs Benjamin B Zhang Lixia L Jackson Dylan D Ganson Kyle K Nagata Jason J

Research square 20230509

Objectives: This study assesses the association between adverse childhood experiences (ACEs) and prescription opioid use during pregnancy. Methods: This study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. The relationship between ACEs and prescription opioid use during pregnancy is examined using multiple logistic regression. Results: The prevalence of prescription opioid use incr ...[more]

PMID: 37214797

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Project description:BackgroundThe 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND.MethodsData for 2161 women were drawn from the 2017-2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to "Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?" (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An "Any violence" variable was created if participants reported "yes" to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any).ResultsAI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures.DiscussionInterpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.

Project description:BackgroundPreterm births represent approximately 10% of all births in the United States (US) annually. Although North Dakota (ND) has large rural and American Indian populations that experience disparities in health outcomes relative to the general population, few studies have investigated risk factors of preterm births in this state. Therefore, the objective of this study was to investigate predictors of preterm births in ND among women who had a live singleton birth and no prior history of preterm births.MethodsData on live births from 2017 to 2021 were obtained from the ND Pregnancy Risk Assessment Monitoring System. Potential predictors of preterm birth were identified using a conceptual model. Multivariable logistic regression was then used to investigate and identify significant predictors of preterm births.ResultsThe overall prevalence of preterm birth in North Dakota from 2017 to 2021 was 8.1%. However, among the population of interest in this study, which excluded births with multiple infants as well as women with a prior history of preterm birth, the preterm birth rate was 6.4%. Race, age, pregestational diabetes, and gestational hypertension were significantly associated with preterm birth in the final multivariable logistic model. The odds of preterm birth were higher among women who were American Indian (adjusted odds ratio (AOR) = 1.7, 95% confidence interval (CI) [1.3-2.4]), were aged 35 years or older (AOR = 1.6, 95% CI [1.01-2.5]), had pregestational diabetes (AOR = 4.3, 95% CI [2.0-9.3]), and had gestational hypertension (AOR = 4.5, 95% CI [3.1-6.7]) compared to women who were White, aged 20-34 years, and did not have pregestational diabetes or gestational hypertension.ConclusionsPreventing and controlling chronic diabetes and hypertensive disorders of pregnancy is critical for reducing the risk of preterm birth, especially among women of advanced maternal age. Further research is needed to understand the underlying causes of racial disparities of preterm birth in ND.

Project description:This study estimates the prevalence of prescription opioid use (POU) in the United States (US) in 2019–2020, both in the general population and specifically among adults with pain. It also identifies key geographic, demographic, and socioeconomic correlates of POU. Data were from the nationally-representative National Health Interview Survey 2019 and 2020 (N = 52,617). We estimated POU prevalence in the prior 12 months among all adults (18+), adults with chronic pain (CP), and adults with high-impact chronic pain (HICP). Modified Poisson regression models estimated POU patterns across covariates. We found POU prevalence of 11.9% (95% CI 11.5, 12.3) in the general population, 29.3% (95% CI 28.2, 30.4) among those with CP, and 41.2% (95% CI 39.2, 43.2) among those with HICP. Findings from fully-adjusted models include the following: In the general population, POU prevalence declined about 9% from 2019 to 2020 (PR = 0.91, 95% CI 0.85, 0.96). POU varied substantially across US geographic regions: It was significantly more common in the Midwest, West, and especially the South, where adults had 40% higher POU (PR = 1.40, 95% CI 1.26, 1.55) than in the Northeast. In contrast, there were no differences by rural/urban residence. In terms of individual characteristics, POU was lowest among immigrants and among the uninsured, and was highest among adults who were food insecure and/or not employed. These findings suggest that prescription opioid use remains high among American adults, especially those with pain. Geographic patterns suggest systemic differences in therapeutic regimes across regions but not rurality, while patterns across social characteristics highlight the complex, opposing effects of limited access to care and socioeconomic precarity. Against the backdrop of continuing debates about benefits and risks of opioid analgesics, this study identifies and invites further research about geographic regions and social groups with particularly high or low prescription opioid use.

Project description:IntroductionData on adverse childhood experiences are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect adverse childhood experiences data may be affected by item nonresponse. This study examines differences in nonresponse to the optional Behavioral Risk Factor Surveillance System adverse childhood experiences module overall, by sociodemographic characteristics, by year, and by question.MethodsThis study used Behavioral Risk Factor Surveillance System adverse childhood experiences module data from 21 states in 2019 and 16 states in 2021. Weighted proportions and 95% CIs of responders and nonresponders to the adverse childhood experiences module by year and sociodemographic characteristics and percentages of nonresponders for each question were calculated. Chi-square tests were used to assess statistically significant (p<0.05) differences. Analyses were conducted in 2023.ResultsIn 2019 and 2021, 1.2% (95% CI=1.1, 1.4) and 2.4% (95% CI=2.2, 2.5) of Behavioral Risk Factor Surveillance System participants were nonresponders to the adverse childhood experiences module, respectively (p<0.01). Nonresponders were more likely to be non-Hispanic Black (p=0.01) or non-Hispanic Asian (p=0.01), to be unemployed (p<0.01), to have income <$15,000 (p<0.01), or to report poor health (p<0.01) than responders. Nonresponse by question increased as the module progressed, and nonresponse was highest for sexual abuse questions.ConclusionsOverall, findings demonstrate that individuals are willing to respond to the adverse childhood experiences module questions. Although low, nonresponse to the module increased from 2019 to 2021. Higher nonresponse for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher nonresponse among racial/ethnic minorities and economically disadvantages groups highlights opportunities to improve existing surveillance systems.

Dataset Information

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020.

Publications

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020.

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