Racial and Ethnic Differences in Postpartum Pain and Opioid Consumption after Cesarean Delivery

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Health Disparities

Background:

• Retrospective studies indicated potential racial/ethnic disparities in postpartum pain and analgesia after cesarean delivery.
• This study prospectively examined racial and ethnic differences in postpartum pain and opioid consumption.

Purpose of the Study:

• To prospectively investigate racial and ethnic variations in postpartum pain intensity.
• To assess racial and ethnic differences in opioid analgesic consumption following cesarean delivery.

Main Methods:

• Prospective observational study (2018-2021) involving 641 women undergoing cesarean delivery.
• Validated questionnaires assessed psychological factors and pain; nurses recorded pain scores and opioid administration on postoperative days 0-2.
• Analyses of covariance controlled for demographic and surgical variables to compare racial/ethnic groups.

Main Results:

• African American and Hispanic/Latina patients reported significantly higher average and maximal postpartum pain severity compared to Asian and White patients.
• African American and Hispanic/Latina patients received higher normalized opioid doses (MME/hour) than Asian and White patients.
• No significant racial or ethnic differences were found in preoperative psychological factors like anxiety or depression.

Conclusions:

• Racial and ethnic disparities exist in postpartum pain and opioid use following cesarean delivery.
• Psychological factors assessed did not explain these disparities, suggesting other psychosocial influences.
• Future research should explore factors like discrimination and resilience to identify intervention targets.