ArticleThe Journal of allergy and clinical immunology2024
Nonsteroidal anti-inflammatory drug "allergy" labeling is associated with increased postpartum opioid utilization.
Article in The Journal of allergy and clinical immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Structural evolution of lotus seed resistant starch duringFrontiers in nutrition · 2026Article
- Targeting IL-4/IL-13 Signaling Pathways in Chronic Rhinosinusitis with Nasal Polyps: From Mechanisms to Therapies.Clinical reviews in allergy & immunology · 2025Review
- The incidence of hypersensitivity to non-steroid anti-inflammatory drugs in the group of patients with rheumatoid musculoskeletal disorders: the cross-sectional study.Rheumatology international · 2025Article
- Aspirin and nonsteroidal anti-inflammatory drug hypersensitivity evaluations in pregnancy: A case series of initiating low-dose aspirin.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2025Article
- Labeled NSAID hypersensitivity and the risk of opioid prescribing; an observational study.Frontiers in allergy · 2025Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCurrent guidelines recommend a stepwise approach to postpartum pain management, beginning with acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), with opioids added only if needed. Report of a prior NSAID-induced adverse drug reaction (ADR) may preclude use of first-line analgesics, despite evidence that many patients with this allergy label may safely tolerate NSAIDs.
objectiveWe assessed the association between reported NSAID ADRs and postpartum opioid utilization.
methodsWe performed a retrospective cohort study of birthing people who delivered within an integrated health system (January 1, 2017, to December 31, 2020). Study outcomes were postpartum inpatient opioid administrations and opioid prescriptions at discharge. Statistical analysis was performed on a propensity score-matched sample, which was generated with the goal of matching to the covariate distributions from individuals with NSAID ADRs.
resultsOf 38,927 eligible participants, there were 883 (2.3%) with an NSAID ADR. Among individuals with reported NSAID ADRs, 49.5% received inpatient opioids in the postpartum period, compared to 34.5% of those with no NSAID ADRs (difference = 15.0%, 95% confidence interval 11.4-18.6%). For patients who received postpartum inpatient opioids, those with NSAID ADRs received a higher total cumulative dose between delivery and hospital discharge (median 30.0 vs 22.5 morphine milligram equivalents [MME] for vaginal deliveries; median 104.4 vs 75.0 MME for cesarean deliveries). The overall proportion of patients receiving an opioid prescription at the time of hospital discharge was higher for patients with NSAID ADRs compared to patients with no NSAID ADRs (39.3% vs 27.2%; difference = 12.1%, 95% confidence interval 8.6-15.6%).
conclusionPatients with reported NSAID ADRs had higher postpartum inpatient opioid utilization and more frequently received opioid prescriptions at hospital discharge compared to those without NSAID ADRs, regardless of mode of delivery.
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