ArticleWomen's health issues : official publication of the Jacobs Institute of Women's Health
Prescription Opioid Dose After Vaginal Delivery and the Risk of Serious Opioid-Related Events: A Retrospective Cohort Study.
Article in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Impact of Prescription Drug Monitoring Programs on Postpartum Opioid Prescribing Practices.Health services research · 2026Article
- Postpartum Opioid Use in the United States and the Implications to Maternal and Public Health: A Scoping Review.Maternal and child health journal · 2025Article
- A spatiotemporal analysis of opioid prescriptions in Indiana from 2015 to 2019.Substance abuse treatment, prevention, and policy · 2025Article
- The impact of different strategies for modeling associations between medications at low doses and health outcomes: a simulation study and practical application to postpartum opioid use.American journal of epidemiology · 2025Article
- Opioid analgesic and antidepressant use during pregnancy and the risk of spontaneous preterm birth: A nested case-control study.Paediatric and perinatal epidemiology · 2025Article
- Changes in Postpartum Opioid Prescribing After Implementation of State Opioid Prescribing Limits.JAMA health forum · 2024Observational
- Nonsteroidal anti-inflammatory drug "allergy" labeling is associated with increased postpartum opioid utilization.The Journal of allergy and clinical immunology · 2024Article
- Opioid and non-opioid analgesic regimens after fracture and risk of serious opioid-related events.Trauma surgery & acute care open · 2024Article
- The risk of serious opioid-related events associated with common opioid prescribing regimens in the postpartum period after cesarean delivery.American journal of obstetrics & gynecology MFM · 2021Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
purposePostpartum opioid use remains common among women with uncomplicated vaginal delivery and may increase the risk of serious opioid-related events. Therefore, we examined the association between the dose of the first filled opioid prescription after vaginal delivery and the subsequent risk of serious opioid-related events.
methodsWe conducted a retrospective cohort study among women enrolled in Tennessee Medicaid with a vaginal delivery (2007-2015). We used Cox proportional hazards regression to model adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for serious opioid-related events after delivery according to the dose (morphine milligram equivalents [MME]) of the first postpartum opioid prescription, accounting for comorbidities, medication use, parity, and delivery complications. Serious opioid-related events were defined as the occurrence of persistent opioid use, a methadone or buprenorphine fill, opioid use disorder diagnosis, opioid overdose, or opioid-related death. We used filled pharmacy data to characterize the dose of the first postpartum opioid prescription filled within 4 days after delivery.
resultsMore than one-half of women (53.2%; n = 147,598) filled an opioid prescription within 4 days of a vaginal delivery. After accounting for baseline risk factors, filling a postpartum opioid prescription was associated with an increased risk of serious opioid-related events across all dose categories, compared with women filling none (aHR 1-99 MME, 1.52; 95% CI, 1.33-1.74; aHR 100-149 MME, 1.41; 95% CI, 1.26-1.58; aHR 150-199 MME, 1.40; 95% CI, 1.26-1.57: and aHR ≥200 MME, 1.60; 95% CI, 1.43-1.78).
conclusionsFilling a postpartum opioid prescription after a vaginal delivery was associated with an increased risk of serious opioid-related events, regardless of dose. Prescribing guidelines should discourage the routine prescribing of opioids after vaginal delivery.
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Registered trials
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.