Oral Opioid Use during Vaginal Delivery Hospitalizations

Mirella Mourad; Ruth Landau; Jason D. Wright; Zainab Siddiq; Cassandra R. Duffy; Adina R. Kern-Goldberger; Mary E. D'Alton; Alexander M. Friedman

doi:10.1055/s-0039-1678566

American Journal of Perinatology, Table of Contents

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

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

,

Ruth Landau

²Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

,

Jason D. Wright

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

,

Zainab Siddiq

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

,

Cassandra R. Duffy

¹Division 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

¹Division 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

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

,

Alexander M. Friedman

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York

› Author Affiliations

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

Full Text

References

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Supplementary Material

Supplementary Material