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Adverse Childhood Experiences and Postcesarean Opioid Use: Does Labor Status Matter? [ID 985]
Jordan Burgess1, Noor Joudi, Elizabeth B Sherwin
1Stanford University School of Medicine, Stanford, CA.
Obstetrics and Gynecology
|May 15, 2025
Summary
Adverse childhood experiences (ACEs) were linked to higher postpartum opioid use in cesarean deliveries without labor. This suggests labor presence may modify the impact of early life trauma on pain management after surgery.
Area of Science:
- Obstetrics and Gynecology
- Trauma-Informed Care
- Pain Management
Background:
- Adverse childhood experiences (ACEs) are linked to increased pain and opioid use post-cesarean delivery (CD).
- Prior trauma may influence pain perception during labor, potentially affecting postpartum outcomes.
Purpose of the Study:
- To investigate the association between ACEs and postpartum opioid consumption.
- To determine if this association differs based on whether labor occurred before CD.
Main Methods:
- Prospective cohort study of 134 individuals undergoing CD.
- ACEs assessed via questionnaire 24-48 hours postpartum.
- Opioid use measured in MMEs/length of stay; moderate-to-high use defined as ≥50th percentile.
Main Results:
- 58% of participants had an unlabored CD; 41% reported ≥1 ACE.
- ACEs associated with higher opioid use in unlabored CD (63% vs. 38%, P=.04).
- ACEs positively correlated with opioid use in unlabored CD (r=0.32, P=.01) but not labored CD (r=0.1, P=.44).
Conclusions:
- ACEs are associated with increased postpartum opioid use specifically in unlabored cesarean deliveries.
- Labor presence appears to modify the relationship between ACEs and opioid consumption.
- Further research is needed to understand ACEs as an effect modifier in post-CD pain.
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