Opioid prescription patterns among pregnant women on Medicaid in Montana and effect on adverse birth outcomes Öffentlichkeit
Fernandez, Daisy (Spring 2018)
Published
Abstract
Background: The last two decades have seen an increase in prescription of opioids among pregnant women. Nonetheless, the association between opioid prescription in pregnancy and adverse birth outcomes is unclear. Further, prescription patterns among Medicaid-enrolled pregnant women in Montana have yet to be explored. This study identifies opioid prescription patterns among pregnant women on Medicaid in Montana, while exploring the association between opioid prescription, preterm birth and small for gestational age (SGA). This work also provides a look at patterns among Medicaid-enrolled American Indian and Alaska Native pregnant mothers in Montana, for which information on opioid prescription is limited.
Methods: Through a retrospective cohort study of 6,947 Medicaid claim records, the prenatal opioid prescription patterns of women in Montana who delivered from 2009 to 2015 were assessed. Additionally, the association between opioid prescription during pregnancy and adverse birth outcomes was analyzed.
Results: From 2009 to 2015, 28.5% of women on Medicaid were prescribed an opioid during pregnancy. The average age of mothers who received a prescription was 24.9 years (SD: 5.4) and most were white, did not smoke during pregnancy, and had a high school diploma. Similarly, the average age for mothers who did not receive a prescription was 24.1 (SD: 5.8) and most were also white, did not smoke, and had a high school diploma. Of the sample, 21.8% had a preterm birth and 11.1% had a SGA birth. Additionally, 25.9% of American Indian or Alaska Native mothers were prescribed an opioid during pregnancy. Lastly, among mothers who had a preterm birth, the odds of having an opioid prescribed during pregnancy was 1.20 (95% CI: 1.06-1.37). No association was found between opioid prescription and SGA.
Conclusion: Over a quarter of women on Medicaid in Montana were prescribed an opioid during pregnancy. This is alarming given that opioid prescription during pregnancy was found to be associated with preterm birth. These results push for further research on the safety of opioid use during pregnancy and encourage medical providers to proceed with caution when prescribing opioids to mothers until more comprehensive information on the effects of opioid use during pregnancy is available.
Table of Contents
CHAPTER I: Background and Literature Review.................1
CHAPTER II: Manuscript.................................................9
Introduction.................................................................9
Methods.....................................................................12
Results.......................................................................19
Discussion...................................................................21
References.................................................................26
Figures and Tables......................................................31
CHAPTER III: Public Health Implications.........................37
APPENDIX: Additional Figures and Tables.......................40
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