Letters

9 June 2020

Opioid Prescribing After Childbirth and Risk for Serious Opioid-Related Events: A Cohort Study

Authors: Sarah S. Osmundson, MD, MS, Jea Young Min, PharmD, PhD, Andrew D. Wiese, PhD, MPH, Robert E. Hawley, BS, Edward Mitchel, BS, Stephen W. Patrick, MD, MPH, MS, Lauren R. Samuels, PhD, Marie R. Griffin, MD, MPH, and Carlos G. Grijalva, MD, MPHAuthor, Article, & Disclosure Information

Publication: Annals of Internal Medicine

Volume 173, Number 5

https://doi.org/10.7326/M19-3805

Background: Although persistent opioid use after surgery, including cesarean birth, has been described, the risk for overdose and other serious opioid-related events (SOREs) after childbirth, specifically vaginal birth, remains unclear (1, 2).

Objective: To assess risk for SOREs associated with postpartum opioid prescribing after childbirth, including both vaginal and cesarean births.

Methods and Findings: We studied women aged 15 to 44 years enrolled in Tennessee Medicaid (TennCare) who were discharged after childbirth between 1 January 2007 and 20 August 2014. TennCare data were supplemented with birth certificate information and hospital discharge data from the Tennessee Hospital Discharge Data …

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References

1.

Bateman BT, Franklin JM, Bykov K, et al. Persistent opioid use following cesarean delivery: patterns and predictors among opioid-naïve women. Am J Obstet Gynecol. 2016;215:353.1-353.e18. [PMID: 26996986] doi: 10.1016/j.ajog.2016.03.016

2.

Osmundson SS, Wiese AD, Min JY, et al. Delivery type, opioid prescribing, and the risk of persistent opioid use after delivery [Letter]. Am J Obstet Gynecol. 2019;220:405-7. [PMID: 30955527] doi: 10.1016/j.ajog.2018.10.026

3.

Peahl AF, Dalton VK, Montgomery JR, et al. Rates of new persistent opioid use after vaginal or cesarean birth among US women. JAMA Netw Open. 2019;2:e197863. [PMID: 31348508] doi: 10.1001/jamanetworkopen.2019.7863

4.

ACOG committee opinion no, 742: postpartum pain management. Obstet Gynecol. 2018;132:e35-e43. [PMID: 29781876] doi: 10.1097/AOG.0000000000002683

5.

Martin JA, Hamilton BE, Osterman MJK. Births in the United States, 2016. NCHS Data Brief. 2017:1-8. [PMID: 29155684]

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine

Annals of Internal Medicine

Volume 173 • Number 5 • 1 September 2020

Pages: 412 - 414

History

Published online: 9 June 2020

Published in issue: 1 September 2020

Keywords

Copyright

© 2020 American College of Physicians.

Authors

Affiliations

Sarah S. Osmundson, MD, MS

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Jea Young Min, PharmD, PhD

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Andrew D. Wiese, PhD, MPH

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Robert E. Hawley, BS

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Edward Mitchel, BS

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Stephen W. Patrick, MD, MPH, MS

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Lauren R. Samuels, PhD

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Marie R. Griffin, MD, MPH

Vanderbilt University Medical Center, Nashville, Tennessee (S.S.O., J.Y.M., A.D.W., R.E.H., E.M., S.W.P., L.R.S., M.R.G.)

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Carlos G. Grijalva, MD, MPH

Vanderbilt University Medical Center and Veterans Health Administration Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Center (GRECC), Nashville, Tennessee (C.G.G.)

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Note: Dr. Osmundson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Disclaimer: The funders of the study had no role in the design of the study, analysis or interpretation of the data, or writing of the report. The corresponding author had final responsibility for the decision to submit the manuscript for publication.

Acknowledgment: The authors thank the Tennessee Division of TennCare of the Department of Finance and Administration and the Tennessee Department of Health for providing data for the study.

Financial Support: Dr. Osmundson was supported by grants K12HD04348317 from the National Institutes of Health and K23DA047476 from the National Institute on Drug Abuse. Dr. Min was supported by the Veterans Affairs Office of Academic Affiliations. Dr. Wiese was supported by the Vanderbilt Faculty Research Scholars program and a PhRMA Foundation Fellowship in Health Outcomes. Dr. Patrick was supported by grant K23DA038720 from the National Institute on Drug Abuse. The study was supported in part by the National Institutes of Health, National Institute on Aging, through grant R01AG043471.

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3805.

Reproducible Research Statement: Study protocol and statistical code: Available from Dr. Osmundson (e-mail, [email protected]). Data set: Not available.

Corresponding Author: Sarah S. Osmundson, MD, MS, 1161 21st Avenue, South B1118 MCN, Nashville, TN 37232; e-mail, [email protected].

This article was published at Annals.org on 9 June 2020.

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Sarah S. Osmundson, Jea Young Min, Andrew D. Wiese, et al. Opioid Prescribing After Childbirth and Risk for Serious Opioid-Related Events: A Cohort Study. Ann Intern Med.2020;173:412-414. [Epub 9 June 2020]. doi:10.7326/M19-3805

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