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Patterns of Opioid Utilization in Pregnancy in a Large Cohort of Commercial Insurance Beneficiaries in the United States

Anesthesiology (Philadelphia), 2014-05, Vol.120 (5), p.1216-1224 [Peer Reviewed Journal]

2014 American Society of Anesthesiologists, Inc. ;2015 INIST-CNRS ;ISSN: 0003-3022 ;EISSN: 1528-1175 ;DOI: 10.1097/ALN.0000000000000172 ;PMID: 24525628 ;CODEN: ANESAV

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  • Title:
    Patterns of Opioid Utilization in Pregnancy in a Large Cohort of Commercial Insurance Beneficiaries in the United States
  • Author: Bateman, Brian T ; Hernandez-Diaz, Sonia ; Rathmell, James P ; Seeger, John D ; Doherty, Michael ; Fischer, Michael A ; Huybrechts, Krista F
  • Subjects: Adult ; Analgesics, Opioid - administration & dosage ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cohort Studies ; Drug Utilization - trends ; Female ; Humans ; Insurance Benefits - trends ; Insurance, Health - trends ; Medical sciences ; Pregnancy - drug effects ; Prevalence ; United States - epidemiology
  • Is Part Of: Anesthesiology (Philadelphia), 2014-05, Vol.120 (5), p.1216-1224
  • Description: BACKGROUND:There are few data regarding the utilization of opioids during pregnancy. The objective of this study was to define the prevalence and patterns of opioid use in a large cohort of pregnant women who were commercial insurance beneficiaries. METHODS:Data for the study were derived from a deidentified research database of women from across the United States who had both medical and prescription benefits. By using diagnostic codes, the authors defined a cohort of 534,500 women with completed pregnancies who were enrolled in a commercial insurance plan from 6 months before pregnancy through delivery. RESULTS:Overall, 76,742 women (14.4%) were dispensed an opioid at some point during pregnancy. There were 30,566 women (5.7%) dispensed an opioid during the first trimester, 30,434 women (5.7%) during the second trimester, and 34,906 women (6.5%) during the third trimester. Of these, 11,747 women (2.2%) were dispensed opioids three or more times during pregnancy. The most commonly dispensed opioids during pregnancy were hydrocodone (6.8%), codeine (6.1%), and oxycodone (2.0%). The prevalence of exposure at anytime during pregnancy decreased slightly during the study period from 14.9% for pregnancies that delivered in 2005 to 12.9% in 2011. The prevalence of exposure varied significantly by region and was lowest in the Northeast and highest in the South. CONCLUSIONS:This study demonstrates that opioids are very common exposures during pregnancy. Given the small and inconsistent body of literature on their safety in pregnancy, these findings suggest a need for research in this area.
  • Publisher: Hagerstown, MD: American Society of Anesthesiologists, Inc
  • Language: English
  • Identifier: ISSN: 0003-3022
    EISSN: 1528-1175
    DOI: 10.1097/ALN.0000000000000172
    PMID: 24525628
    CODEN: ANESAV
  • Source: MEDLINE
    Alma/SFX Local Collection
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