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Am J Perinatol 2020; 37(04): 390-397
DOI: 10.1055/s-0039-1678566
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Oral Opioid Use during Vaginal Delivery Hospitalizations

Mirella Mourad
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Ruth Landau
2   Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Jason D. Wright
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Zainab Siddiq
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Cassandra R. Duffy
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Adina R. Kern-Goldberger
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Mary E. D'Alton
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
,
Alexander M. Friedman
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
› Author Affiliations Funding A.M.F. is supported by a career development award (K08HD082287) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
Further Information

Publication History

07 August 2018

12 January 2019

Publication Date:
12 February 2019 (online)

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Abstract

Objective This study aimed to determine the receipt of short-acting opioid medications during vaginal delivery hospitalizations.

Study Design The Perspective database was analyzed to evaluate patterns of short-acting oral opioid use during vaginal delivery hospitalizations from January 2006 to March 2015. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created evaluating use of opioids. Hospital-level rates of opioid use were evaluated. Opioid receipt among women with opioid abuse or dependence was evaluated based on overall hospital rates of opioid use.

Results Of 3,785,396 vaginal delivery hospitalizations from 2006 to 2015, 1,720,899 (45.5%) women received an oral opioid for pain relief. Opioid use varied significantly among the 458 hospitals included in the analysis, with one-third of hospitals providing opioids to <38% of patients, one-third to 38 to <59% of patients, and one-third to ≥59% of patients. When hospitals were stratified by overall opioid administration rates, women with opioid abuse or dependence were less likely to be given opioids in hospitals with low overall opioid rates.

Discussion The use of opioid pain medications during vaginal delivery hospitalizations varied significantly among hospitals, suggesting that standardization of pain management practices could reduce opioid use.

Keywords

opioids - pregnancy - hospital variation - opioid dependence

Authors' Contribution

All authors fulfilled all conditions required for authorship and approved this submission. Specifically, A.M.F. and M.M. conceived the study question and study design. Z.S. performed the data analysis. M.M., A.M.F., and R.L. drafted the manuscript. J.D.W., C.R.D., A.R.K., and M.E.D. made substantial contributions to the conception and design of the study, as well as interpretation of the data. They also made substantial contributions in drafting the article and revising it critically.


Note

This study was presented as an abstract at the 2018 Society for Maternal–Fetal Medicine Pregnancy Meeting in Dallas, TX.


Ethical Approval

Given that the Perspective database is publicly available and identified, the Columbia University Institutional Review Board granted a waiver for this analysis.


Supplementary Material

 

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