بررسی میزان بروز سوء مصرف مواد و پیامدهای بارداری زنان باردار معتاد مراجعه‌کننده به بیمارستان آیت‌الله روحانی بابل بین سالهای 98-1396 (یک مطالعه کوهورت تاریخی)

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی دکترای بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران. واحد توسعه تحقیقات بالینی آیت‌الله روحانی بابل، دانشگاه علوم پزشکی بابل، بابل، ایران.

2 استاد گروه زنان و مامایی، مرکز تحقیقات بهداشت باروری و ناباروری، پژوهشکده سلامت، دانشگاه علوم پزشکی بابل، بابل، ایران.

3 کارشناس ارشد مامایی، واحد توسعه تحقیقات بیمارستان آیت‌الله روحانی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی بابل، بابل، ایران.

4 استادیار گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

5 استاد گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

10.22038/ijogi.2022.20713

چکیده

مقدمه: اعتیاد به مواد مخدر سبب عوارضی همچون زایمان زودرس، سقط، عقب ماندگی رشد داخل رحمی، مرگ‌و‌میر پره‌ناتال، دکولمان جفت، پره‌اکلامپسی، پارگی زودرس کیسه آب، افزایش سزارین و ناهنجاری‌های مادرزادی می‌شود، لذا مطالعه حاضر با هدف بررسی میزان شیوع سوء مصرف مواد و پیامدهای بارداری انجام گرفت.
روش‌کار: این مطالعه به‌صورت دو مرحله‌ای انجام شد؛ در ابتدا یک مطالعه مقطعی در تمامی زنان باردار مراجعه‌کننده به زایشگاه بیمارستان آیت‌الله روحانی بابل در فروردین 1396 تا اسفند 1398 و سپس یک مطالعه کوهورت تاریخی انجام گرفت؛ به این‌صورت که افراد مورد مطالعه به دو گروه (112 زن باردار معتاد و 224 زن باردار غیر‌معتاد) تقسیم شدند. ابزار گردآوری داده‌ها چک‌لیست محقق‌ساخته شامل: اطلاعات دموگرافیک، عوارض مادری و عوارض جنینی- نوزادی بود. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) و آزمون‌های آماری تی‌تست و کای اسکوئر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در این مطالعه بروز سوء مصرف مواد در بین 6713 زن باردار طی این 3 سال، 66/1% بود. عوارض مادری، جنینی و نوزادی در بین مادران با سابقه سوء‌مصرف مواد در مقایسه با گروه شاهد افزایش معناداری را نشان داد (0001/0=p). پارگی زودرس کیسه آب در 44 نفر (28/39%) و سپس زایمان زودرس در 32 نفر (57/28%) شایع‌ترین عوارض بودند. شانس پارگی زودرس کیسه آب 09/9 برابر با دامنه اطمینان 95% (211/0-058/0) و شانس زایمان زودرس 5 برابر با دامنه اطمینان 95% (388/0-107/0) در مادران با سابقه سوء‌مصرف مواد بالاتر بود. شانس دیسترس تنفسی در نوازان متولد شده از مادران معتاد 10 برابر با دامنه اطمینان 95% (227/0-058/0) بیشتر بود.
نتیجه‌گیری: اعتیاد در دوران بارداری با عوارض مادری، جنینی و نوزادی زیادی همراه می‌باشد، لذا توصیه می‌شود برنامه­ای جامع و اختصاصی جهت انجام اقدامات تشخیص، درمانی و بازتوانی به‌ویژه کاهش صدمات ناشی از اعتیاد برای زنان انجام گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

egnant women referred to Ayatollah Rouhani Hospital in Babol from 2017 to 2019 (a historical cohort study)

نویسندگان [English]

  • Mina Galshi 1
  • Zeinat Sadat Bouzari 2
  • Mojgan Naimi Rad 3
  • Shahla Yazdani 2
  • Solmaz Talebi 4
  • Afsaneh Keramat 5
1 PhD Student in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
2 Professor, Department of Obstetrics and Gynecology, Reproductive Health and Infertility Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
3 M.Sc. of Midwifery, Clinical Research Development Unit of Rouhani Hospital, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran.
4 Assistant Professor, Department of Biostatistics, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
5 Professor, Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
چکیده [English]

Introduction: Drug addiction causes complications such as preterm delivery, miscarriage, intrauterine growth retardation, prenatal mortality, placental abruption, preeclampsia, premature rupture of membranes, increased cesarean section and congenital anomalies. Therefore, this study was performed aimed to investigate the prevalence of substance abuse and pregnancy outcomes.
Methods: This study was conducted in two stages, initially a cross-sectional study was performed in all pregnant women referred to the maternity ward of Ayatollah Rouhani Hospital in Babol from April 2017 to March 2019. Then, a historical cohort study was conducted in which the subjects were divided into two groups: 112 addicted pregnant women and 224 non-addicted pregnant women. Data collection tool was a researcher-made checklist including: demographic information, maternal complications, and fetal-neonatal complications. Data were analyzed using SPSS software (version 21) and T-test and Chi-square test. P<0.05 was considered statistically significant.
Results: The prevalence of addiction was 1.66% among 6713 pregnant women during these three years. Maternal, fetal and neonatal complications showed a significant increase among addicted mothers compared to the control group (P = 0.0001). Premature rupture of membranes in 44 women (39.28%) and preterm delivery in 32 (28.57%) were the most common complications. The chance of premature rupture of the amniotic sac was 9.09 times with a 95% confidence interval (0.058-0.211) and the chance of preterm delivery was 5 times higher with a 95% confidence interval (0.107-0.388) in addicted mothers. The chance of respiratory distress in infants born to addicted mothers was 10 times higher with a 95% confidence interval (0.058-0.227).
Conclusion: Addiction during pregnancy is associated with many maternal, fetal and neonatal complications, so it is recommended that a comprehensive and specific program be performed for diagnostic, treatment and rehabilitation measures, especially to reduce the damage caused by addiction for women.

کلیدواژه‌ها [English]

  • Addiction
  • Complications
  • pregnancy
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