Dataset Information

Parenteral Pethidine for labour pain relief and substance use disorder: 20-year follow-up cohort study in offspring.

ABSTRACT: To determine whether use of intrapartum Pethidine pain analgesia increases the risk for substance use disorder in adult offspring. Analysis of data from a cohort study. Academic hospital in Leiden, the Netherlands. 133 cases and 164 control individuals, aged 18-20 years at follow-up. Incidence of substance use disorder or use of alcohol and tobacco. The lifetime use of addictive substances in children exposed to intrapartum Pethidine analgesia was 45% of 133 children versus 48% of 164 not-exposed subjects (adjusted OR=0.79, 95% CI 0.48 to 1.29). Recent use of alcohol, tobacco and hard drugs showed no statistical difference either. Pethidine for labour pain medication appears not to be associated with substance misuse or smoking in later life.

SUBMITTER: Pereira RR

PROVIDER: S-EPMC3367141 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Parenteral Pethidine for labour pain relief and substance use disorder: 20-year follow-up cohort study in offspring.

Pereira Robert Rodrigues RR Kanhai Humphrey H Rosendaal Frits F van Dommelen Paula P Swaab Dick D Rodrigues Pereira Erik E van de Wetering Ben B

BMJ open 20120530 3

<h4>Objective</h4>To determine whether use of intrapartum Pethidine pain analgesia increases the risk for substance use disorder in adult offspring.<h4>Design</h4>Analysis of data from a cohort study.<h4>Setting</h4>Academic hospital in Leiden, the Netherlands.<h4>Participants</h4>133 cases and 164 control individuals, aged 18-20 years at follow-up.<h4>Main outcome measure</h4>Incidence of substance use disorder or use of alcohol and tobacco.<h4>Results</h4>The lifetime use of addictive substanc ...[more]

PMID: 22649173

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Project description:Background: Peripartum anesthesia may consist of parenteral opioids and/or regional analgesia. There is only limited data in the literature comparing both methods in daily obstetric practice. This observational study investigated the opioids pethidine and meptazinol as well as regional analgesics with regard to their administration, efficacy, side effects and subjective maternal satisfaction with therapy. The rates of secondary regional analgesia administration after administration of the respective opioid served as a means of evaluating treatment. Methods: This study collected data on pain management during vaginal delivery in a German university hospital over a twelve month period. Severity of pain was measured intrapartum using a numerical rating scale. Maternal, neonatal and delivery-related data were obtained postpartum from the clinical records and from the mothers using a questionnaire. Results: The study is based on data obtained from 449 deliveries. Pain relief achieved by the administration of pethidine and meptazinol was similarly low; maternal satisfaction with the respective therapy was high. Meptazinol was usually administered intravenously (83 % vs. 6 %; p < 0.001), repeatedly (27 % vs. 6 %; p < 0.001) and closer to the birth (1.9 ± 2.7 h vs. 2.6 ± 2.8 h; p < 0.05) compared to pethidine. Secondary regional analgesia was more common after the administration of pethidine (16 % vs. 8 %; p < 0.05). Regional analgesia resulted in greater pain relief compared to opioid therapy (78 % vs. 24 % after 30 min; p < 0.001) and was associated with longer times to delivery (7.6 ± 2.5 h vs. 5.7 ± 2.5 h; p < 0.001) and higher levels of maternal satisfaction with therapy (6.1 ± 1.2 vs. 4.8 ± 1.6 on a 7-point scale; p < 0.001). Conclusion: In daily clinical practice, meptazinol can be adapted more readily to changes during birth and requires less secondary analgesia. Regional neuraxial analgesia was found to be an efficacious and safe way of managing labor pain.

Project description:A meta-analysis was performed on studies employing the ventricular-brain ratio to compare schizophrenic subjects to that of normal controls. This was a follow-up to a similar meta-analysis published in 1992 in which study-, in addition to clinical-, factors were found to contribute significantly to the reported difference between patients with schizophrenia and controls. Seventy-two (N=72) total studies were identified from the peer reviewed literature, 39 from the original meta-analysis, and 33 additional studies published since which met strict criteria for inclusion and analysis - thus representing ~30 years of schizophrenia ventricular enlargement research. Sample characteristics from schizophrenics and controls were coded for use as predictor variables against within sample VBR values as well as for between sample VBR differences. Additionally, a number of factors concerning how the studies were conducted and reported were also coded. Obtained data was subjected to unweighted univariate as well as multiple regression analyses. In particular, results indicated significant differences between schizophrenics and controls in ventricular size but also the influence of the diagnostic criteria used to define schizophrenia on the magnitude of the reported VBR. This suggests that differing factors of the diagnostic criteria may be sensitive to ventricular enlargement and might be worthy of further examination. Interestingly, we observed an inverse relationship between VBR difference and the number of co-authors on the study. This latter finding suggests that larger research groups report smaller VBR differences and may be more conservative or exacting in their research methodology. Analyses weighted by sample size provided identical conclusions. The effects of study factors such as these are helpful for understanding the variation in the size of the reported differences in VBR between patients and controls as well as for understanding the evolution of research on complex clinical syndromes employing neuroimaging morphometrics.

Dataset Information

Parenteral Pethidine for labour pain relief and substance use disorder: 20-year follow-up cohort study in offspring.

Publications

Parenteral Pethidine for labour pain relief and substance use disorder: 20-year follow-up cohort study in offspring.

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