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Opium use during pregnancy and risk of preterm delivery: A population-based cohort study
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden.
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden.
Örebro University, School of Medical Sciences. Orebro University Hospital. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden; Clinical Epidem iology and Biostatistic s, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Epidemiology and Public Health, University College London, United Kingdom.ORCID iD: 0000-0001-6328-5494
Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 4, e0176588Article in journal (Refereed) Published
Abstract [en]

Background: Use of narcotic or "recreational" drugs has been associated with adverse pregnancy outcomes such as preterm delivery. However, the associations might be confounded by other factors related to high-risk behaviours. This is the first study to investigate the association between traditional opium use during pregnancy and risk of preterm delivery.

Method and findings: We performed a population-based cohort study in the rural areas of the Golestan province, Iran between 2008 and 2010. We randomly selected 920 women who used (usually smoked) opium during pregnancy and 920 women who did not. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations between the opium use during pregnancy and preterm delivery and adjustment was made for potential confounding factors. This study shows compared with non-use of opium and tobacco, use of only opium during pregnancy was associated with an increased risk of preterm delivery (OR = 1.56; 95% CI 1.05-2.32), and the risk was more than two-fold increased among dual users of opium and tobacco (OR = 2.31; 95% CI 1.37-3.90). We observed that opium use only was associated with a doubled risk for preterm caesarean delivery (OR = 2.05; 95% CI 1.10-3.82) but not for preterm vaginal delivery (OR = 1.25; 95% CI 0.75-2.07). Dual use of opium and tobacco was associated with a substantially increased risk of vaginal preterm delivery (OR = 2.58; 95% CI 1.41-4.71).

Conclusions: Opium use during pregnancy among non-tobacco smokers is associated with an increased risk of preterm caesarean delivery, indicating an increased risk of a compromised foetus before or during labour. Women who use both opium and smoked during pregnancy have an increased risk of preterm vaginal delivery, indicating an increased risk of spontaneous preterm delivery.

Place, publisher, year, edition, pages
Public Library of Science , 2017. Vol. 12, no 4, e0176588
National Category
Substance Abuse
Identifiers
URN: urn:nbn:se:oru:diva-57870DOI: 10.1371/journal.pone.0176588ISI: 000400383600109PubMedID: 28448546ScopusID: 2-s2.0-85018309362OAI: oai:DiVA.org:oru-57870DiVA: diva2:1103898
Note

Funding Agency:

Karolinska Institute

Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2017-05-31Bibliographically approved

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