Evidence map›Paper›PMID 33350491›Full record

ArticlePaediatric and perinatal epidemiology2021

A population-based study of concurrent prescriptions of opioid analgesic and selective serotonin reuptake inhibitor medications during pregnancy and risk for adverse birth outcomes.

Ayesha C Sujan, Martin E Rickert, Patrick D Quinn, Christina Ludema, Kelsey K Wiggs, Henrik Larsson, Paul Lichtenstein, Catarina Almqvist, Anna Sara Öberg, Brian M D'Onofrio

Open access · greenAbstract read
In one paragraph

Article in Paediatric and perinatal epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 19% 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

7 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Trends in prenatal prescription opioid use among Medicaid beneficiaries in Wisconsin, 2010-2019.Journal of perinatology : official journal of the California Perinatal Association · 2024
    Article
  4. Use of Population-Level Administrative Data in Developmental Science.Annual review of developmental psychology · 2022
    Article
  5. Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Ayesha C SujanDepartment of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.ORCID 0000-0002-4374-9949
Martin E RickertDepartment of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.
Patrick D QuinnDepartment of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA.
Christina LudemaDepartment of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA.
Kelsey K WiggsDepartment of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.
Henrik LarssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Paul LichtensteinDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Catarina AlmqvistDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-1045-1898
Anna Sara ÖbergDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Brian M D'OnofrioDepartment of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.
Indiana University Bloomington · USKarolinska Institutet · SEHarvard University · USÖrebro University · SE

Funding

Maternal use of prescribed opioid analgesics and risk of adverse offspring outcomesR01DA048042 · NIDA · TRUSTEES OF INDIANA UNIVERSITY · PI D'ONOFRIO, BRIAN M, OBERG, ANNA SARA · 2019 to 2021
$1.2M
Pharmacoepidemiologic Studies of Prescription Opioid Analgesic RisksR00DA040727 · NIDA · TRUSTEES OF INDIANA UNIVERSITY · PI QUINN, PATRICK DONOVAN · 2018 to 2020
$744k
NIDA NIH HHS R00 DA040727NIDA NIH HHS R00DA040727NIDA NIH HHS R01 DA048042NIDA NIH HHS R01DA048042
6 · The paper itself

Abstract

backgroundPregnant women with painful conditions often have mental health problems, including depression and anxiety. Co-morbid conditions may cause pregnant women to use multiple medications, although safety of such practice is poorly understood.

objectivesWe investigated the influence of combined prescriptions of opioid analgesics and selective serotonin reuptake inhibitors (SSRIs) during pregnancy on two adverse birth outcomes.

methodsWe analysed Swedish population-based births (n = 688 914) between 2007 and 2013. Using national registers, we obtained data on filled medication prescriptions, birth outcomes, and a wide range of parental characteristics. We estimated preterm birth and small-for-gestational-age risk following independent or combined prescriptions of the two medications compared with no filled prescriptions for either medication. We adjusted for confounders using inverse probability of treatment weights.

resultsAfter adjusting for confounders, preterm birth risk was higher among women with opioid analgesic prescriptions only (5.9%; risk ratio [RR] 1.27, 95% confidence interval [CI] 1.22, 1.33), SSRIs only (6.2%; RR 1.34, 95% CI 1.27, 1.42), and both medications (7.8%; RR 1.70, 95% CI 1.47, 1.96) compared with unexposed women (4.6%). The interaction between the medications on preterm birth was small (risk difference [RD] 0.4%, 95% CI -0.8%, 1.6%); relative excess risk due to interaction [RERI] 0.09, 95% CI -0.17, 0.34; RR 1.00, 95% CI 0.85, 1.17). For small for gestational age, risk was approximately 2% across all groups, and there was no interaction between the medications (RD 0.3%, 95% CI -0.4%, 1.1%); RERI 0.15, 95% CI -0.16, 0.47; RR 1.15, 95% CI 0.87, 1.52).

conclusionsCompared with unexposed pregnancies, those with either medication alone had a small increased risk for preterm birth but no increased risk for small for gestational age. The magnitude of associations with combined exposure to both medications were not greater than the sum of the associations with each medication considered individually.

Indexed as

Analgesics, OpioidPremature BirthFemaleHumansInfant, NewbornInfant, Small for Gestational AgePregnancyPrescriptionsSelective Serotonin Reuptake InhibitorsAnalgesics, OpioidSelective Serotonin Reuptake Inhibitorsantidepressant drugsopioid analgesicpolypharmacyprenatal carepreterm birthsmall-for-gestational-age infant

Identifiers

PMID33350491
PMCPMC7878346
OpenAlexW3113828294

What OpenQuestion holds

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Registered trials

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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.