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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e275-e280
DOI: 10.1055/s-0040-1716906
Original Article

Associations among Discharge Opioid Prescribing and Inpatient Postpartum Opioid Usage after Delivery

Ashley Veade
1   Department of Obstetrics and Gynecology, Washington University of St. Louis, St. Louis, Missouri
,
Tyler McKinnish
1   Department of Obstetrics and Gynecology, Washington University of St. Louis, St. Louis, Missouri
,
Ebony Carter
2   Division of Maternal Fetal Medicine, Washington University of St. Louis, Saint Louis, Missouri
,
Adam Lewkowitz
3   Division of Maternal Fetal Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
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Abstract

Objective The aim of the study is to identify an association between inpatient opioid consumption and prescription at discharge after vaginal delivery (VD) and cesarean delivery (CD).

Methods This retrospective cohort study included women with an active inpatient opioid order after VD or CD between July and October of 2018 at a single academic tertiary hospital. Women with opioid use disorder, 3rd or 4th degree lacerations, wound complications, and peripartum hysterectomy were excluded. Oxycodone 5-mg (mg) tablets consumed postpartum and prescribed at discharge and sociodemographics were recorded. Primary outcome was the number of oxycodone 5-mg tablets prescribed at discharge. Outcomes were analyzed using multivariable logistic regression between quartiles of inpatient opioid consumption.

Results A total of 437 patients were included: 169 patients underwent VD, and 268 underwent CD. For VD and CD, women in the highest quartile of inpatient opioid consumption were more likely Black compared with the lowest quartile (p = 0.006 and p = 0.004, respectively). No association existed between inpatient opioid use and number of tablets prescribed at discharge for VD or CD (odds ratio [OR] 0.22 [95% confidence interval or CI 0.02–2.17] and OR 1.04 [95% CI 0.85–1.32], respectively).

Conclusion The number of opioid tablets prescribed at discharge had no association with inpatient postpartum consumption after VD or CD.

Keywords

opioids - vaginal delivery - cesarean delivery - postpartum

Authors' Contribution

T.M. contributed toward data collection (tyler.mckinnish@wustl.edu). E.C. managed project oversight and manuscript reviewing (ebcarter@wustl.edu). A.L. handled project oversight, statistical analysis, and manuscript reviewing (aklew@gmail.com).


Note

Presented at: The Annual Meeting of the Society for Maternal-Fetal Medicine (SMFM), The Pregnancy Meeting™, February 3–8, 2020, Grapevine, Tx.




Publication History

Received: 21 May 2020

Accepted: 20 July 2020

Article published online:
23 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Seth P, Scholl L, Rudd RA, Bacon S. Overdose deaths involving opioids, cocaine, and psychostimulants—United States, 2015-2016. MMWR Morb Mortal Wkly Rep 2018; 67 (12) 349-358
    CrossrefPubMedGoogle Scholar
  • 2 Peahl AF, Dalton VK, Montgomery JR, Lai YL, Hu HM, Waljee JF. Rates of new persistent opioid use after vaginal or cesarean birth among US women. JAMA Netw Open 2019; 2 (07) e197863
    CrossrefPubMedGoogle Scholar
  • 3 Prabhu M, Garry EM, Hernandez-Diaz S, MacDonald SC, Huybrechts KF, Bateman BT. Frequency of opioid dispensing after vaginal delivery. Obstet Gynecol 2018; 132 (02) 459-465
    CrossrefPubMedGoogle Scholar
  • 4 Bateman BT, Cole NM, Maeda A. et al. Patterns of opioid prescription and use after cesarean delivery. Obstet Gynecol 2017; 130 (01) 29-35
    CrossrefPubMedGoogle Scholar
  • 5 ACOG Committee Opinion No. ACOG Committee Opinion No. 742 summary: postpartum pain management. Obstet Gynecol 2018; 132 (01) 252-253
    CrossrefPubMedGoogle Scholar
  • 6 Alcántara Montero A, Sánchez Carnerero CI, Ibor Vidal PJ, Alonso Verdugo A. CDC guidelines for prescribing opioids for chronic pain. Semergen 2017; 43 (04) e53-e54
    CrossrefPubMedGoogle Scholar
  • 7 Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016; 65 (01) 1-49
    CrossrefPubMedGoogle Scholar
  • 8 Badreldin N, Grobman WA, Yee LM. Inpatient opioid use after vaginal delivery. Am J Obstet Gynecol 2018; 219 (06) 608.e1-608.e7
    CrossrefPubMedGoogle Scholar
  • 9 Osmundson SS, Schornack LA, Grasch JL, Zuckerwise LC, Young JL, Richardson MG. Post discharge opioid use after cesarean delivery. Obstet Gynecol 2017; 130 (01) 36-41
    CrossrefPubMedGoogle Scholar
  • 10 Badreldin N, Grobman WA, Chang KT, Yee LM. Opioid prescribing patterns among postpartum women. Am J Obstet Gynecol 2018; 219 (01) 103.e1-103.e8
    CrossrefPubMedGoogle Scholar
  • 11 Prabhu M, McQuaid-Hanson E, Hopp S. et al. A shared decision-making intervention to guide opioid prescribing after cesarean delivery. Obstet Gynecol 2017; 130 (01) 42-46
    CrossrefPubMedGoogle Scholar