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Opioid use during pregnancy: a population-based cohort study.

Jamie Falk1, Matthew Dahl1, Colette B Raymond1

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Opioid use during pregnancy declined, but the overall volume and potency of opioids used by continuing mothers increased significantly. This highlights the need for ongoing evaluation and education on opioid risks for pregnant women.

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Pharmacology

Background:

  • Opioid use has surged in North America, raising concerns about pregnancy safety.
  • Opioid use during pregnancy is linked to fetal abnormalities and neonatal abstinence syndrome.
  • Limited data exists on opioid safety during pregnancy.

Purpose of the Study:

  • To examine opioid use patterns before and during pregnancy in a comprehensive population-based cohort.
  • To quantify trends in opioid prescription and dosage among pregnant women.

Main Methods:

  • A population-based cohort study of all pregnant women in Manitoba, Canada (2001-2013).
  • Opioid use defined by prescription data, converted to oral morphine equivalents (MEQ).
  • Analysis of opioid use in the 3 months pre-pregnancy and each trimester.

Main Results:

  • 6.7% of women used opioids pre-pregnancy, declining to 2.9-4.2% during pregnancy.
  • Overall opioid use increased modestly from 7.3% to 7.7% during the study.
  • Mean MEQ increased significantly (284 mg to 1218 mg), with codeine being the most common opioid.

Conclusions:

  • While many women reduced opioid use in pregnancy, those who continued did not decrease their overall consumption.
  • Increasing opioid dosage and potency among pregnant users necessitates further evaluation and education.
  • The findings underscore the importance of understanding the benefits and risks of opioid use during pregnancy.