Opioid prescribing trends in postpartum women: a multicenter study

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Pharmacology

Background:

• The postpartum period presents a critical window for opioid medication exposure.
• Current medical practice lacks consensus guidelines for opioid prescribing in postpartum care.

Purpose of the Study:

• To assess inter- and intrahospital variations in opioid prescribing patterns for postpartum women.
• To investigate the influence of clinical variables on postpartum opioid prescription decisions.

Main Methods:

• Retrospective analysis of electronic medical records for 4248 postpartum patients across 6 US hospitals (January-March 2016).
• Primary outcome: opioid prescription at hospital discharge.
• Statistical analyses included chi-squared tests and ANOVA to evaluate prescription frequency and morphine equivalent dose, controlling for confounding factors like age, parity, and delivery route.

Main Results:

• Significant interhospital variation in postpartum opioid prescription rates (27.6%–70.9%, P < .001).
• Oxycodone-acetaminophen was the most frequent prescription (50.3%); median tablets ranged from 20–40.
• Primiparous women and those with second- or third-/fourth-degree lacerations were more likely to receive opioids.

Conclusions:

• Wide variations in postpartum opioid prescribing exist among healthcare facilities.
• Intrahospital prescribing trends were more consistent, suggesting a need for standardized national guidelines for postpartum pain management.