Prescription opioid use during pregnancy and risk for preterm birth or term low birthweight

2021 ◽  
Vol 17 (3) ◽  
pp. 215-225
Author(s):  
Julia D. Interrante, MPH ◽  
Stacey L. P. Scroggs, PhD ◽  
Carol J. Hogue, PhD ◽  
Jan M. Friedman, MD ◽  
Jennita Reefhuis, PhD ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Low Birthweight ◽  
Opioid Analgesic ◽  
Population Based ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Increased Risk ◽  
Potential Risks ◽  
Prescription Opioid Use

Objective: Examine the relationship between prescription opioid analgesic use during pregnancy and preterm birth or term low birthweight.Design, setting, and participants: We analyzed data from the National Birth Defects Prevention Study, a US multisite, population-based study, for births from 1997 to 2011. We defined exposure as self-reported prescription opioid use between one month before conception and the end of pregnancy, and we dichotomized opioid use duration by ≤7 days and 7 days.Main outcome measures: We examined the association between opioid use and preterm birth (defined as gestational age 37 weeks) and term low birthweight (defined as 2500 g at gestational age ≥37 weeks).Results: Among 10,491 singleton mother/infant pairs, 470 (4.5 percent) reported opioid use. Among women reporting opioid use, 236 (50 percent) used opioids for 7 days; codeine (170, 36 percent) and hydrocodone (163, 35 percent) were the most commonly reported opioids. Opioid use was associated with slightly increased risk for preterm birth [adjusted odds ratio, 1.4; 95 percent confidence interval, 1.0, 1.9], particularly with hydrocodone [1.6; 1.0, 2.6], meperidine [2.5; 1.2, 5.2], or morphine [3.0; 1.5, 6.1] use for any duration; however, opioid use was not significantly associated with term low birthweight.Conclusions: Preterm birth occurred more frequently among infants of women reporting prescription opioid use during pregnancy. However, we could not determine if these risks relate to the drug or to indications for use. Patients who use opioids during pregnancy should be counseled by their practitioners about this and other potential risks associated with opioid use in pregnancy. 

scholarly journals Abnormal Glycemic Control, Obesity, and Increased Infection Risk in Patients on Chronic Opioid Therapy

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Glycemic Control ◽  
Opioid Therapy ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Care Workers ◽  
Increased Risk ◽  
Potential Risks ◽  
Prescription Opioid Use ◽  
Relationship Of ◽  
The Relationship

Since 2007, the rate of opioids prescribing has steadily increased among physicians more likely to manage acute and chronic pain. Most health care workers are well aware of prescription opioid-related risks of addiction and overdose; however, the recent studies have shown other potential risks such as: abnormal glycemic control, obesity, and increased risk of infections. In this review, we discuss the latest available evidence examining the relationship of prescription opioid use with increased obesity, abnormal glycemic control, and risk of infections.

scholarly journals Determinants of prescription opioid use: population‐based evidence from Finland

Addiction ◽  
2020 ◽  
Vol 116 (1) ◽  
pp. 170-175 ◽  
Author(s):  
Petri Böckerman ◽  
Mika Haapanen ◽  
Christian Hakulinen ◽  
Hannu Karhunen ◽  
Terhi Maczulskij
Keyword(s):  
Population Based ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

scholarly journals Combined effect of posttraumatic stress disorder and prescription opioid use on risk of cardiovascular disease

2019 ◽  
Vol 27 (13) ◽  
pp. 1412-1422 ◽  
Author(s):  
Jeffrey F Scherrer ◽  
Joanne Salas ◽  
Patrick Lustman ◽  
Peter Tuerk ◽  
Sarah Gebauer ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Opioid Analgesic ◽  
Hazard Ratio ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Increased Risk ◽  
Exposure Variable

Aim Prescription opioid analgesic use (OAU) is associated with increased risk of cardiovascular disease (CVD). OAU is more common in patients with than without posttraumatic stress disorder (PTSD), and PTSD is associated with higher CVD risk. We determined whether PTSD and OAU have an additive or multiplicative association with incident CVD. Methods and results Veterans Health Affairs patient medical record data from 2008 to 2015 was used to identify 2861 patients 30–70 years of age, free of cancer, CVD and OAU for 12 months before index date. We defined a four-level exposure variable: 1) no PTSD/no OAU, 2) OAU alone, 3) PTSD alone and 4) PTSD+OAU. Cox proportional hazard models estimated the association between the exposure variable and incident CVD. The mean age was 49.0 (±11.0), 85.7% were male and 58.3% were White, 34.4% had no PTSD/no OAU, 32.9% had PTSD alone, 10.6% had OAU alone, and 22.1% had PTSD+OAU. Compared with patients with no PTSD/no OAU, those with PTSD alone were not at increased risk of incident CVD (hazard ratio = 0.82; 95% confidence interval (CI): 0.63–1.17); however, OAU alone and PTSD+OAU were both significantly associated with incident CVD (hazard ratio = 1.99; 95% CI:1.36–2.92 and hazard ratio = 2.20; 95% CI: 1.61–3.02). There was no significant additive or multiplicative PTSD and OAU association with incident CVD. Conclusion OAU is associated with nearly a two-fold increased risk of CVD in patients with and without PTSD. Despite no additive or multiplicative interaction effects, the high prevalence of OAU in PTSD may represent a novel contributor to the elevated CVD burden among patients with PTSD.

scholarly journals Correlates and consequences of central sleep apnea in a national sample of US veterans

SLEEP ◽  
2018 ◽  
Vol 41 (9) ◽  
Author(s):  
David Ratz ◽  
Wyndy Wiitala ◽  
M Safwan Badr ◽  
Jennifer Burns ◽  
Susmita Chowdhuri
Keyword(s):  
Sleep Apnea ◽  
Hospital Admissions ◽  
Comparison Group ◽  
Central Sleep Apnea ◽  
Prescription Opioid ◽  
Cardiovascular Disorders ◽  
Health Administration ◽  
Opioid Use ◽  
Increased Risk ◽  
Prescription Opioid Use

AbstractThe prevalence and consequences of central sleep apnea (CSA) in adults are not well described. By utilizing the large Veterans Health Administration (VHA) national administrative databases, we sought to determine the incidence, clinical correlates, and impact of CSA on healthcare utilization in Veterans. Analysis of a retrospective cohort of patients with sleep disorders was performed from outpatient visits and inpatient admissions from fiscal years 2006 through 2012. The CSA group, defined by International Classification of Diseases-9, was compared with a comparison group. The number of newly diagnosed CSA cases increased fivefold during this timeframe; however, the prevalence was highly variable depending on the VHA site. The important predictors of CSA were male gender (odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.94–2.76, p < 0.0001), heart failure (HF) (OR = 1.78, 95% CI: 1.64–1.92, p < 0.0001), atrial fibrillation (OR = 1.83, 95% CI: 1.69–2.00, p < 0.0001), pulmonary hypertension (OR = 1.38, 95% CI:1.19–1.59, p < 0.0001), stroke (OR = 1.65, 95% CI: 1.50–1.82, p < 0.0001), and chronic prescription opioid use (OR = 1.99, 95% CI: 1.87–2.13, p < 0.0001). Veterans with CSA were at an increased risk for hospital admissions related to cardiovascular disorders compared with the comparison group (incidence rate ratio [IRR] = 1.50, 95% CI: 1.16–1.95, p = 0.002). Additionally, the effect of prior HF on future admissions was greater in the CSA group (IRR: 4.78, 95% CI: 3.87–5.91, p < 0.0001) compared with the comparison group (IRR = 3.32, 95% CI: 3.18–3.47, p < 0.0001). Thus, CSA in veterans is associated with cardiovascular disorders, chronic prescription opioid use, and increased admissions related to the comorbid cardiovascular disorders. Furthermore, there is a need for standardization of diagnostics methods across the VHA to accurately diagnose CSA in high-risk populations.

scholarly journals Association between initial opioid prescription diagnosis type and subsequent chronic prescription opioid use in Rhode Island: a population-based cohort study

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e050540
Author(s):  
Benjamin D Hallowell ◽  
Laura C Chambers ◽  
Luke Barre ◽  
Nancy Diao ◽  
Collette Onyejekwe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Rhode Island ◽  
Population Based ◽  
Primary Outcome Measure ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Management Approaches ◽  
Opioid Users ◽  
Prescription Opioid Use

ObjectiveTo identify initial diagnoses associated with elevated risk of chronic prescription opioid use.DesignPopulation-based, retrospective cohort study.SettingState of Rhode Island.ParticipantsRhode Island residents with an initial opioid prescription dispensed between 1 April 2019 and 31 March 2020.Primary outcome measureSubsequent chronic prescription opioid use, defined as receiving 60 or more days’ supply of opioids in the 90 days following an initial opioid prescription.ResultsAmong the 87 055 patients with an initial opioid prescription, 3199 (3.7%) subsequently became chronic users. Patients who become chronic users tended to receive a longer days’ supply, greater quantity dispensed, but a lower morphine milligram equivalents on the initial opioid prescription. Patients prescribed an initial opioid prescription for diseases of the musculoskeletal system and connective tissue (adjusted OR (aOR): 5.9, 95% CI: 4.7 to 7.6), diseases of the nervous system (aOR: 6.3, 95% CI: 4.9 to 8.0) and neoplasms (aOR: 5.6, 95% CI: 4.2 to 7.5) had higher odds of subsequent chronic prescription opioid use, compared with a referent group that included all diagnosis types with fewer than 15 chronic opioid users, after adjusting for confounders.ConclusionsBy focusing interventions and prescribing guidelines on specific types of diagnoses that carry a high risk of chronic prescription opioid use and diagnoses that would benefit equally or more from alternative management approaches, states and healthcare organisations may more efficiently decrease inappropriate opioid prescribing while improving the quality of patient care.

Prescription opioid use among drivers in British Columbia, 1997–2016

2021 ◽  
pp. injuryprev-2020-043989
Author(s):  
John A Staples ◽  
Shannon Erdelyi ◽  
Jessica Moe ◽  
Mayesha Khan ◽  
Herbert Chan ◽  
...  
Keyword(s):  
British Columbia ◽  
Geographical Variation ◽  
Temporal Trends ◽  
Population Based ◽  
Opioid Consumption ◽  
Prescription Opioid ◽  
Prescription Data ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Prescription Opioid Use

BackgroundOpioids increase the risk of traffic crash by limiting coordination, slowing reflexes, impairing concentration and producing drowsiness. The epidemiology of prescription opioid use among drivers remains uncertain. We aimed to examine population-based trends and geographical variation in drivers’ prescription opioid consumption.MethodsWe linked 20 years of province-wide driving records to comprehensive population-based prescription data for all drivers in British Columbia (Canada). We calculated age- and sex-standardised rates of prescription opioid consumption. We assessed temporal trends using segmented linear regression and examined regional variation in prescription opioid use using maps and graphical techniques.ResultsA total of 46 million opioid prescriptions were filled by 3.0 million licensed drivers between 1997 and 2016. In 2016 alone, 14.7% of all drivers filled at least one opioid prescription. Prescription opioid use increased from 238 morphine milligram equivalents per driver year (MMEs/DY) in 1997 to a peak of 834 MMEs/DY in 2011. Increases in MMEs/DY were greatest for higher potency and long-acting prescription opioids. The interquartile range of prescription opioid dispensation by geographical region increased from 97 (Q1=220, Q3=317) to 416 (Q1=591, Q3=1007) MMEs/DY over the study interval.ImplicationsPatterns of prescription opioid consumption among drivers demonstrate substantial temporal and geographical variation, suggesting they may be modified by clinical and policy interventions. Interventions to curtail use of potentially impairing prescription medications might prevent impaired driving.

scholarly journals The role of cancer in marijuana and prescription opioid use in the United States: A population‐based analysis from 2005 to 2014

Cancer ◽  
2019 ◽  
Author(s):  
Kathryn R. Tringale ◽  
Minh‐Phuong Huynh‐Le ◽  
Mia Salans ◽  
Deborah C. Marshall ◽  
Yuyan Shi ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Population Based ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

scholarly journals Maternal lithium use and the risk of adverse pregnancy and neonatal outcomes: a Swedish population-based cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Roxanne Hastie ◽  
Stephen Tong ◽  
Richard Hiscock ◽  
Anthea Lindquist ◽  
Linda Lindström ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Gestational Age ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Adjusted Relative Risk ◽  
Spontaneous Preterm Birth ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Background Lithium is prescribed during pregnancy, but there is limited information about pregnancy and neonatal outcomes following in utero exposure. Thus, this study aimed to investigate the associations between lithium use and adverse pregnancy and neonatal outcomes. Methods This population-based cohort study examined associations between maternal lithium use and major adverse pregnancy and neonatal outcomes via inverse probability weighted propensity score regression models. Results Of 854,017 women included in this study, 434 (0.05%) used lithium during pregnancy. Among pre-specified primary outcomes, lithium use during pregnancy was associated with an increased risk of spontaneous preterm birth (8.7% vs 3.0%; adjusted relative risk [aRR] 2.64 95% CI 1.82, 3.82) and birth of a large for gestational age infant (9.0% vs 3.5%; aRR 2.64 95% CI 1.91, 3.66), but not preeclampsia nor birth of a small for gestational age infant. Among secondary outcomes, lithium use was associated with an increased risk of cardiac malformations (2.1% vs 0.8%; aRR 3.17 95% CI 1.64, 6.13). In an analysis restricted to pregnant women with a diagnosed psychiatric illness (n=9552), associations remained between lithium and spontaneous preterm birth, birth of a large for gestational age infant, and cardiovascular malformations; and a positive association with neonatal hypoglycaemia was also found. These associations were also apparent in a further analysis comparing women who continued lithium treatment during pregnancy to those who discontinued prior to pregnancy. Conclusions Lithium use during pregnancy is associated with an increased risk of spontaneous preterm birth and other adverse neonatal outcomes. These potential risks must be balanced against the important benefit of treatment and should be used to guide shared decision-making.

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