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Filled Prescriptions for Opioids After Vaginal Delivery
Marian Jarlenski1, Lisa M Bodnar, Joo Yeon Kim
1Departments of Health Policy and Management and Epidemiology, Graduate School of Public Health, the Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, and the Division of General Academic Pediatrics, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, and Magee-Womens Research Institute, Pittsburgh, Pennsylvania.
Obstetrics and Gynecology
|February 9, 2017
Summary
Over 10% of women filled opioid prescriptions after vaginal delivery. This highlights the need for national guidelines on opioid prescribing for common obstetrics procedures.
Area of Science:
- Obstetrics and Gynecology
- Pain Management
- Public Health
Background:
- Opioid prescriptions are common following childbirth, but data on prevalence after vaginal delivery are limited.
- Understanding prescription patterns is crucial for developing targeted interventions and guidelines.
Purpose of the Study:
- To estimate the prevalence of filled opioid prescriptions among women after vaginal delivery.
- To identify factors associated with opioid prescription fills in the postpartum period.
Main Methods:
- Retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania (2008-2013).
- Excluded women with opioid use during pregnancy or opioid use disorder.
- Assessed opioid prescription fills within 5 days and 6-60 days postpartum, considering pain-inducing conditions like perineal laceration or episiotomy.
Main Results:
- 12% of women filled an opioid prescription within 5 days postpartum.
- 1.6% filled a second opioid prescription between 6-60 days postpartum.
- Tobacco use and mental health conditions were associated with opioid fills even without documented pain-inducing conditions.
Conclusions:
- More than 1 in 10 women receive outpatient opioid prescriptions after vaginal delivery.
- National opioid-prescribing recommendations for common obstetrics procedures, including vaginal delivery, are warranted.