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///2018 Abstract Details
2018 Abstract Details2019-08-02T15:57:01-05:00

Long acting opioid use during delivery hospitalizations and risk for severe maternal morbidity

Abstract Number: T1B-4
Abstract Type: Original Research

Cassandra Duffy MD1 ; Ling Chen MD2; Ruth Landau MD3; Jason D Wright MD4; Mary E D'Alton MD5; Alexander M Friedman MD6

Introduction

Currently, there is limited data on long acting opioid (LAO) use during delivery hospitalizations including whether women using these medications are at increased risk for severe maternal morbidity (SMM). The objectives of this study were: (i) to assess use of and hospital variation in LAOs during delivery hospitalizations, and (ii) determine risk for SMM among LAO users.

Methods

An administrative inpatient database that includes medications was analyzed to evaluate use of LAOs during delivery hospitalizations from January 2006 through March 2015. Medications included extended-release versions formulations of oxycodone and morphine, buprenorphine, and methadone. Hospital level rates of long acting opioid administration during delivery hospitalizations were calculated. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created. Risk for SMM was determined based on CDC criteria.

Results

4,653,945 delivery hospitalizations meeting criteria were included in the analysis. 1.2% of women received a LAO during their hospitalization. Risk of SMM was significantly higher for women receiving a LAO compared to other women (3.0% vs. 1.6% p<0.001). The Figure demonstrates rates of LAO use by hospital. Of 497 hospitals, rate of LAO receipt was ≤0.1% for 158 hospitals, >0.1% and <1.0% for 254 hospitals, and ≥1.0% for 85 hospitals; this latter group accounted for majority of LAO use. In adjusted analyses, LAO use was more common among older women, white women, Medicaid recipients, and single women.

Discussion

LAO use varies significantly by center. LAO use is associated with increased risk for SMM. Given that a small proportion of centers will provide care for the majority of women using these medication, it may be possible to improve care and safety via targeted interventions.



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