ArticleAmerican journal of obstetrics & gynecology MFM2021
The risk of serious opioid-related events associated with common opioid prescribing regimens in the postpartum period after cesarean delivery.
Article in American journal of obstetrics & gynecology MFM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 15 citations in OpenAlex.
- Postpartum Opioid Use in the United States and the Implications to Maternal and Public Health: A Scoping Review.Maternal and child health journal · 2025Article
- The association between prenatal depression and persistent postpartum pharmaceutical opioid use in six US states.Pregnancy (Hoboken, N.J.) · 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
- Risk of Opioid Use Disorder in Surgical Patients with Medicaid and Associations with Prescription Opioid Dose and Duration.Journal of pain research · 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
- Perioperative opioid prescribing and iatrogenic opioid use disorder and overdose: a state-of-the-art narrative review.Regional anesthesia and pain medicine · 2024Review
- 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
- Content Quality of YouTube Videos About Pain Management After Cesarean Birth: Content Analysis.JMIR infodemiology · 2023Article
- Obstetrical clinician opioid prescribing perspectives after cesarean delivery in Tennessee.American journal of obstetrics & gynecology MFM · 2023Article
- Women's beliefs of pain after childbirth: Critical insight for promoting behavioral strategies to regulate pain and reduce risks for maternal mortality.Patient education and counseling · 2023Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOpioid analgesics are commonly prescribed to women after cesarean delivery. There is a growing effort to prescribe opioids judiciously; however, the risk of serious opioid-related events associated with specific prescribing patterns after cesarean delivery remains unclear.
objectiveWe examined the association between the dosage of the first opioid prescription filled after cesarean delivery and the risk of serious opioid-related events. STUDY
designWe identified opioid-naïve women with a cesarean delivery enrolled in Tennessee Medicaid (2007-2014). Pharmacy prescription fill data characterized opioids filled within 5 days after delivery. Patients were followed up from day 5 after delivery to the earliest of the following: serious opioid-related event (persistent opioid use, evidence of opioid use disorder [diagnosis or methadone or buprenorphine fill], overdose, or opioid-related death), non-opioid-related death, enrollment loss, or 365th day. We estimated the adjusted hazard ratios and 95% confidence intervals for the serious opioid-related event outcomes based on the dosage (morphine milligram equivalents) of the first filled opioid prescription, adjusting for baseline sociodemographic characteristics, delivery complications, multiple deliveries, comorbidities, and medication use. Secondary analyses examined the role of commonly prescribed opioid strengths and quantities.
resultsThe overall incidence rate of serious opioid-related events among women after cesarean delivery was 3.0 per 100 person-years. Compared with women who did not fill an opioid prescription, the rate of serious opioid-related events was higher among women who filled an opioid prescription, although only significantly higher among women who filled a total dosage of ≥100 morphine milligram equivalents (97.1% of opioid prescriptions). In the secondary analyses, women with a low prescribed daily opioid dosage and women with a low prescribed number of oxycodone (5 mg) tablets (<10 tablets) were not at increased risk of serious opioid-related events compared with women who did not fill an opioid prescription.
conclusionOpioid-naïve women who filled a postpartum opioid prescription at commonly prescribed doses after cesarean delivery had an increased risk of serious opioid-related events compared to women who did not fill a postpartum opioid prescription. Low opioid doses were not associated with a significant increase in the risk of serious opioid-related events.
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