Evidence map›Paper›PMID 35640619›Full record

ArticleAmerican journal of perinatology2024

Risk of Death at 1 Year Following Postpartum Opioid Exposure.

Arlyn Horn, Margaret A Adgent, Sarah S Osmundson, Andrew D Wiese, Sharon E Phillips, Stephen W Patrick, Marie R Griffin, Carlos G Grijalva

Open access · greenAbstract read
In one paragraph

Article in American journal of perinatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 17% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
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 2 institutions in 1 country.

Arlyn Horn *Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Margaret A Adgent *Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.ORCID 0000-0002-5951-5514
Sarah S OsmundsonDepartment of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee.
Andrew D WieseDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Sharon E PhillipsDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
Stephen W PatrickDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Marie R GriffinDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Carlos G GrijalvaDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University Medical Center · USVA Tennessee Valley Healthcare System · US

Funding

Building Interdisciplinary Research Careers in Women's HealthK12HD043483 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HARTMANN, KATHERINE E, MAJOR, AMY S · 2002 to 2023
$10.3M
Opioid selection and the risk of serious infections in older adultsR01AG043471 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G · 2013 to 2017
$2.3M
Reducing Unused Prescribed Opioids After Cesarean BirthK23DA047476 · NIDA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI OSMUNDSON, SARAH SCHEIDERICH · 2019 to 2023
$859k
Benzodiazepine restrictions and the prevention of overdoses and other harmsK01DA051683 · NIDA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WIESE, ANDREW DAVID · 2021 to 2024
$688k
NIA NIH HHS R01 AG043471NICHD NIH HHS K12 HD043483NIDA NIH HHS K01 DA051683NIDA NIH HHS K23 DA047476NIH HHS K23DA047476
6 · The paper itself

Abstract

objectiveOpioids are commonly prescribed to women for acute pain following childbirth. Postpartum prescription opioid exposure is associated with adverse opioid-related morbidities but the association with all-cause mortality is not well studied. This study aimed to examine the association between postpartum opioid prescription fills and the 1-year risk of all-cause mortality among women with live births.

methodsIn a retrospective cohort study of live births among women enrolled in Tennessee Medicaid (TennCare) between 2007 and 2015, we compared women who filled two or more postpartum outpatient opioid prescriptions (up to 41 days of postdelivery discharge) to women who filled one or fewer opioid prescription. Women were followed from day 42 postdelivery discharge through 365 days of follow-up or date of death. Deaths were identified using linked death certificates (2007-2016). We used Cox's proportional hazard regression and inverse probability of treatment weights to compare time to death between exposure groups while adjusting for relevant confounders. We also examined effect modification by delivery route, race, opioid use disorder, use of benzodiazepines, and mental health condition diagnosis.

resultsAmong 264,135 eligible births, 216,762 (82.1%) had one or fewer maternal postpartum opioid fills and 47,373 (17.9%) had two or more fills. There were 182 deaths during follow-up. The mortality rate was higher in women with two or more fills (120.5 per 100,000 person-years) than in those with one or fewer (57.7 per 100,000 person-years). The risk of maternal death remained higher in participants exposed to two or more opioid fills after accounting for relevant covariates using inverse probability of treatment weighting (adjusted hazard ratio: 1.46 [95% confidence interval: 1.01, 2.09]). Findings from stratified analyses were consistent with main findings.

conclusionFilling two or more opioid prescriptions during the postpartum period was associated with a significant increase in 1-year risk of death among new mothers. KEY POINTS: · Opioid prescribing in the postpartum period is common.. · Prior studies show that >1 postnatal opioid fill is associated with adverse opioid-related events.. · > 1 opioid fill within 42 days of delivery was associated with an increase in 1-year risk of death..

Indexed as

Analgesics, OpioidPostpartum PeriodAdultFemaleHumansMedicaidOpioid-Related DisordersPregnancyProportional Hazards ModelsRetrospective StudiesRisk FactorsTennesseeUnited StatesYoung AdultAnalgesics, Opioid

Identifiers

PMID35640619
PMCPMC9708936
OpenAlexW4281622193

What OpenQuestion holds

Textmetadata
LicenceTDM
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.