Evidence map›Paper›PMID 33441038›Full record

ArticleThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians2022

A nation-wide Swedish study of opioid analgesic prescribing patterns during pregnancy and associated preexisting mental health conditions.

Ayesha C Sujan, Patrick D Quinn, Martin E Rickert, Kelsey K Wiggs, Henrik Larsson, Paul Lichtenstein, A Sara Öberg, Brian M D'Onofrio

Abstract read
In one paragraph

Article in The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

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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.

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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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.

Ayesha C SujanDepartment of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.ORCID 0000-0002-4374-9949
Patrick D QuinnDepartment of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA.
Martin E RickertDepartment of Psychological & Brain Sciences, 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.
A 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.ORCID 0000-0002-5248-7434

Funding

Training in Clinical Translational Science: Maximizing the Public Health ImpactT32MH103213 · NIMH · TRUSTEES OF INDIANA UNIVERSITY · PI WILLIAM P HETRICK · 2015 to 2026
$3.4M
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 R01 DA048042NIMH NIH HHS T32 MH103213
6 · The paper itself

Abstract

introductionResearch has consistently shown individuals with mental health conditions are more likely to be prescribed opioid analgesic medications and to engage in heavier utilization. However, it is unclear whether these findings apply to pregnant women. STUDY

designWe explored opioid analgesic prescription in 689,400 pregnancies occurring in Sweden between 2007 and 2013. We investigated prescription patterns across time and type of source clinic for any opioid analgesic and for strong and weak opioid analgesics. We further evaluated the extent to which receipt of opioid analgesic medications was associated with previous mental health diagnoses and prescriptions of other psychoactive medications.

resultsThe prevalence of pregnant women who filled prescriptions for opioid analgesics (4.5%) was relatively stable across the assessed years. However, among pregnant women who filled opioid analgesic prescriptions, there was a large increase in strong opioid analgesic prescriptions-from 6.1% in 2007 to 17.1% in 2013. The main source of opioid analgesic prescriptions were primary care and obstetrics and gynecology clinics-38.7% of all filled prescriptions originated from primary care providers and 25.3% from obstetrics and gynecology practitioners. Compared to pregnant women who did not fill any opioid analgesic prescriptions, those who did were more likely to have a wide range of preexisting mental health diagnoses (e.g. anxiety disorder odds ratio [OR] = 3.13, 95% confidence interval [CI]:2.98,3.29) and to utilize a wide range of other psychoactive medications (e.g. benzodiazepines OR = 4.26, 95% CI:4.10,4.43). Similarly, those who received strong opioids were more likely to have a wide range of mental health diagnoses and be prescribed a wide range of psychoactive medications compared to those who received weak opioids.

conclusionsThese results highlight the need for physicians treating pregnant women and women of childbearing age for painful conditions to obtain detailed histories of mental health problems, screen for symptoms of mental health problems, and facilitate integrated care and evidence-based mental health interventions if needed.

Indexed as

Analgesics, OpioidMental HealthAnalgesicsBenzodiazepinesDrug PrescriptionsFemaleHumansPractice Patterns, Physicians'PregnancySwedenAnalgesicsAnalgesics, OpioidBenzodiazepinesMental healthopioid analgesicspregnancyprenatal careprenatal diagnosis

Identifiers

PMID33441038
PMCPMC10083039

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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.