Table 5.
Crude and adjusted hazard ratio models of the association between opioid exposure during pregnancy and neuropsychiatric disorders in children with the sibling comparison cohort from full unmatched cohort, propensity score matched cohort A, and child screening cohort from 2010 to 2017
| Opioid exposure during pregnancy | No (%) | Neuropsychiatric disorder events (%) | Person years | Neuropsychiatric incidence rate, per 1000 person years | Hazard ratio (95% CI) | ||
|---|---|---|---|---|---|---|---|
| Crude* | Adjusted† | Fully adjusted‡ | |||||
| Sibling cohort A from the full unmatched cohort: | |||||||
| No exposure | 114 007 (52.0) | 5008 (4.4) | 760 040 | 6.6 | 1 (reference) | 1 (reference) | 1 (reference) |
| Exposure | 105 339 (48.0) | 2754 (2.6) | 566 329 | 4.9 | 0.78 (0.73 to 0.82)* | 1.00 (0.93 to 1.07) | 1.00 (0.93 to 1.07) |
| Sibling cohort B from the propensity score matched cohort A: | |||||||
| No exposure | 47 294 (50.7) | 2049 (4.3) | 303 650 | 6.9 | 1 (reference) | 1 (reference) | 1 (reference) |
| Exposure | 46 034 (49.3) | 1391 (3.0) | 255 035 | 5.7 | 0.89 (0.82 to 0.97)* | 1.04 (0.93 to 1.16) | 1.03 (0.92 to 1.16) |
| Sibling cohort C from the child screening cohort: | |||||||
| No exposure | 21 221 (50.6) | 1066 (5.0) | 152 981 | 7.0 | 1 (reference) | 1 (reference) | 1 (reference) |
| Exposure | 20 699 (49.4) | 585 (2.8) | 121 848 | 4.8 | 0.72 (0.63 to 0.80)* | 0.95 (0.82 to 1.12) | 0.95 (0.81 to 1.11) |
CI=confidence interval; MME= morphine milligram equivalents.
Significant differences (P<0.05).
The adjusted model was adjusted for the following variables: maternal age at delivery years (≤19, 20-24, 25-29, 30-34, and ≥35 years), infant sex, region of residence (urban and rural), household income level (1st, 2nd, 3rd, or 4th quartiles), birth season (spring, summer, autumn, or winter), parity (1 or ≥2), maternal mental illness, severe maternal morbidity score (0, 1, or ≥2), and hospital outpatient visit (0, 1, or ≥2), and admission contact (0, 1, or ≥2) in a year before pregnancy.
The fully adjusted model was adjusted for the following variables: covariates as in the adjusted model, history of maternal neuropsychiatric conditions (alcohol or drug misuse, mood disorders except those with psychotic symptoms, anxiety and stress related disorders, sleep disorders, epilepsy, and other neuropsychiatry disorders), and use of NSAIDs and acetaminophen during pregnancy.