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New Persistent Opioid Use After Childbirth

Jonathan S Zipursky1, Karl Everett, Andrew Calzavara

  • 1Department of Medicine, Sunnybrook Health Sciences Centre, ICES, the Sunnybrook Research Institute, the Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, and the Leslie Dan Faculty of Pharmacy and the Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Obstetrics and Gynecology
|November 2, 2023
PubMed

Insights

About 1% of individuals using opioids postpartum developed persistent opioid use. High initial opioid doses and concurrent benzodiazepine prescriptions are key modifiable risk factors for postpartum persistent opioid use.

Area of Science:

  • Obstetrics and Gynecology
  • Pharmacology
  • Public Health

Background:

  • Postpartum persistent opioid use is a significant concern following childbirth.
  • Understanding risk factors is crucial for developing targeted interventions.

Purpose of the Study:

  • To identify factors associated with new persistent opioid use after childbirth.
  • To inform strategies for preventing long-term opioid dependence in postpartum individuals.

Main Methods:

  • Population-based cohort study of 118,694 deliveries with initial opioid prescriptions.
  • Defined new persistent opioid use as opioid prescriptions within 90 days and 91-365 days postpartum.
  • Utilized multivariable logistic regression to analyze patient, pregnancy, and prescription factors.

Main Results:

  • 10.8 per 1,000 deliveries resulted in new persistent opioid use.
  • Higher rates observed after vaginal deliveries (16.0/1,000) vs. cesarean (9.8/1,000).
  • Increased risk associated with higher initial opioid dosage (morphine milligram equivalents) and concurrent benzodiazepine prescriptions.

Conclusions:

  • Approximately 1% of postpartum individuals receiving opioid prescriptions developed persistent use.
  • Large initial opioid quantities and concomitant benzodiazepine prescriptions are significant, modifiable risk factors.
  • These findings highlight targets for interventions to mitigate postpartum opioid use disorder.
Abstract

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