Evidence map›Paper›PMID 25975601›Full record

Observational studyBMJ (Clinical research ed.)2015

Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study.

Rishi J Desai, Krista F Huybrechts, Sonia Hernandez-Diaz, Helen Mogun, Elisabetta Patorno, Karol Kaltenbach, Leslie S Kerzner, Brian T Bateman

Open access · hybridAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 2 pooled it
34.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 2 syntheses or guidelines pooled it, 171 citations in OpenAlex.

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  18. Prevalence of Opioid Use in Nursing Homes Over the Last Decade: A Systematic Literature Review.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2024
    Article
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39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Rishi J DesaiDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA rdesai2@partners.org.
Krista F HuybrechtsDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA.
Sonia Hernandez-DiazDepartment of Epidemiology, Harvard School of Public Health, Boston.
Helen MogunDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA.
Elisabetta PatornoDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA.
Karol KaltenbachDepartment of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Leslie S KerznerDepartment of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Brian T BatemanDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston.
Brigham and Women's Hospital · USHarvard University · USMassachusetts General Hospital · USThomas Jefferson University · US

Funding

Comparative Effectiveness and Safety of Depression Treatments during PregnancyR01HS018533 · AHRQ · HARVARD SCHOOL OF PUBLIC HEALTH · PI HERNANDEZ-DIAZ, SONIA · 2009 to 2013
$2.2M
Improved methods to assess the comparative safety of new psychiatric medicationsK01MH099141 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI HUYBRECHTS, KRISTA F · 2013 to 2017
$882k
Comparative safety & effectiveness of antihypertensive medications in pregnancyK08HD075831 · NICHD · BRIGHAM AND WOMEN'S HOSPITAL · PI BATEMAN, BRIAN THOMAS · 2013 to 2017
$717k
AHRQ HHS R01HS018533NICHD NIH HHS K08 HD075831NICHD NIH HHS K08HD075831NIMH NIH HHS K01 MH099141
6 · The paper itself

Abstract

objectiveTo provide absolute and relative risk estimates of neonatal abstinence syndrome (NAS) based on duration and timing of prescription opioid use during pregnancy in the presence or absence of additional NAS risk factors of history of opioid misuse or dependence, misuse of other substances, non-opioid psychotropic drug use, and smoking.

designObservational cohort study.

settingMedicaid data from 46 US states.

participantsPregnant women filling at least one prescription for an opioid analgesic at any time during pregnancy for whom opioid exposure characteristics including duration of therapy: short term (<30 days) or long term (≥ 30 days); timing of use: early use (only in the first two trimesters) or late use (extending into the third trimester); and cumulative dose (in morphine equivalent milligrams) were assessed.

main outcome measureDiagnosis of NAS in liveborn infants.

results1705 cases of NAS were identified among 290,605 pregnant women filling opioid prescriptions, corresponding to an absolute risk of 5.9 per 1000 deliveries (95% confidence interval 5.6 to 6.2). Long term opioid use during pregnancy resulted in higher absolute risk of NAS per 1000 deliveries in the presence of additional risk factors of known opioid misuse (220.2 (200.8 to 241.0)), alcohol or other drug misuse (30.8 (26.1 to 36.0)), exposure to other psychotropic medications (13.1 (10.6 to 16.1)), and smoking (6.6 (4.3 to 9.6)) than in the absence of any of these risk factors (4.2 (3.3 to 5.4)). The corresponding risk estimates for short term use were 192.0 (175.8 to 209.3), 7.0 (6.0 to 8.2), 2.0 (1.5 to 2.6), 1.5 (1.0 to 2.0), and 0.7 (0.6 to 0.8) per 1000 deliveries, respectively. In propensity score matched analyses, long term prescription opioid use compared with short term use and late use compared with early use in pregnancy demonstrated greater risk of NAS (risk ratios 2.05 (95% confidence interval 1.81 to 2.33) and 1.24 (1.12 to 1.38), respectively).

conclusionsUse of prescription opioids during pregnancy is associated with a low absolute risk of NAS in the absence of additional risk factors. Long term use compared with short term use and late use compared with early use of prescription opioids are associated with increased NAS risk independent of additional risk factors.

Indexed as

AdolescentAdultAnalgesics, OpioidCohort StudiesDose-Response Relationship, DrugFemaleHumansInfantInfant, NewbornMedicaidMethadoneMiddle AgedMorphineNeonatal Abstinence SyndromeOpiate Substitution TreatmentOpioid-Related DisordersAnalgesics, OpioidMethadoneMorphine

Identifiers

PMID25975601
PMCPMC4431352
OpenAlexW2168728317

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.