Incidence of postpartum opioid overdose dying excessive with opioid use dysfunction

Key takeaways :

• Postpartum opioid overdose deaths per 100,000 deliveries had been 5.4 for all ladies and 118 for these with opioid use dysfunction.
• Treating opioid use dysfunction after supply was linked to fewer opioid overdose deaths.

Postpartum ladies with opioid use dysfunction expertise a excessive incidence of postpartum opioid overdose dying, different substance-related accidents, accidents and suicide, in keeping with findings printed in Obstetrics & Gynecology.

due to this fact, people with opioid use dysfunction are excessive threat for postpartum mortality, due to this fact efforts must be made to determine these people and supply them with remedy and help,” Elizabeth A. Suarez, PhD, MPH, teacher and core school on the Rutgers Institute for Well being, Well being Care Coverage and Getting older Analysis and the Rutgers Faculty of Public Well being, advised Healio. “Screening for substance use issues throughout being pregnant is important, and continued follow-up in the course of the postpartum interval could possibly be lifesaving. Initiating or persevering with remedy with buprenorphine or methadone is vitally essential for these sufferers.”

This cohort examine included all pregnant ladies with reside births or stillbirths who had steady enrollment within the Medicaid Analytic eXtract linked to the Nationwide Loss of life Index within the U.S. from 2006 to 2013 for 3 months previous to supply, which led to 4,972,061 deliveries. Researchers additionally recognized a subcohort of 48,902 women with a history of opioid use disorder 3 months previous to supply of which 102 died in the course of the first postpartum 12 months.

Researchers noticed a cumulative incidence of opioid overdose dying of 5.8 per 100,000 deliveries amongst all ladies and 124 per 100,000 deliveries amongst ladies with opioid use dysfunction. Odds of opioid use dying was decrease amongst Asian/Pacific Islander ladies (OR = 0.3; 95% CI, 0-2.1), Hispanic ladies (OR = 0.2; 95% CI, 0.1-0.3) and ladies of different racial/ethnic backgrounds (OR = 0.3; 95% CI, 0.1-0.9) in contrast with white ladies.

As well as, opioid overdose dying was extra seemingly amongst ladies with vs. with out the next:

• being pregnant issues (OR = 4.5; 95% CI, 1.4-14);
• preterm beginning (OR = 2.6; 95% CI, 1.6-4.3);
• cesarean supply (OR = 1.7; 95% CI, 1.2-2.6);
• psychological well being issues (OR = 6.2; 95% CI, 4-9.7);
• tobacco use (OR = 3.2; 95% CI, 2.1-5);
• prescription opioid analgesic indications (OR = 7.3; 95% CI, 4.7-11.4);
• opioid use dysfunction (OR = 26.7; 95% CI, 12.8-55.8); and
• different substance use issues (OR = 9.2; 95% CI, 4.5-18.7)

Postpartum opioid overdose dying incidence per 100,000 deliveries was 5.4 amongst all ladies and 118 amongst these with opioid use dysfunction. Girls with opioid use dysfunction skilled a sixfold greater incidence for all-cause postpartum dying in contrast with all ladies.

The widespread causes of dying amongst ladies with opioid use dysfunction had been different drug- and alcohol-related deaths with 47 incidents per 100,000, suicide with 26 incidents per 100,000 and different accidents together with accidents and falls with 33 incidents per 100,000. Researchers noticed psychological well being and different substance use issues as threat elements that had been strongly related to postpartum opioid overdose dying.

Amongst ladies with opioid use dysfunction, use of remedy to deal with opioid use dysfunction in the course of the postpartum interval was related to 60% decrease odds of opioid overdose dying (OR = 0.4; 95% CI, 0.1-0.9).

“It will be nice to have more moderen information. Once we accomplished this evaluation, we might solely entry dying information by means of 2013. Our examine was additionally too small to check timing of initiation and potential discontinuation of medicines for opioid use dysfunction,” Suarez mentioned. “Whereas we see a lower in threat of dying amongst pregnant people on remedy, the danger might fluctuate primarily based on the steadiness of remedy all through being pregnant and the postpartum interval.”

For extra data:

Elizabeth A. Suarez, PhD, MPH, may be reached at [email protected].