Nichole Nidey1,2, Ryan Carnahan3, Knute D Carter4, Lane Strathearn5,6, Wei Bao3, Andrea Greiner7, Laura Jelliffee-Pawlowski8,9, Karen M Tabb10, Kelli Ryckman3. 1. Department of Pediatrics, Division of Biostatistics and Epidemiology, Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 2. University of Cincinnati College of Medicine, Cincinnati, Ohio. 3. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa. 4. Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa. 5. Stead Family Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa. 6. Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa. 7. Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa. 8. California Preterm Birth Initiative, University of California San Francisco, San Francisco, California. 9. Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California. 10. School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois.
Abstract
BACKGROUND AND OBJECTIVES: Postpartum women represent a large population with opioid exposure who also have an increased risk of experiencing mood and anxiety disorders. However, the effect that mood and anxiety disorders have on opioid use postpartum has received little attention in the literature. Therefore, the objective of this study was to examine the association of mood and anxiety disorders with filling opioid prescriptions within the first 3 months postpartum. METHODS: A retrospective cohort study (n = 25 279) was completed using claims data for a sample of privately insured women who gave birth in the state of Iowa. The interactive effects of mood and anxiety disorders and delivery mode on filling at least one and two or more opioid prescriptions were examined in logistic regression models. RESULTS: The presence of mood and anxiety disorders among women who delivered vaginally increased their odds of filling at least one opioid fill by nearly 50% (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.35-1.63) and by 20% (OR: 1.20, 95% CI: 1.00-1.43) among women with cesarean delivery. DISCUSSION AND CONCLUSION: Postpartum women with mood and anxiety disorders were more likely to fill opioid prescriptions postpartum compared to women without these conditions. SCIENTIFIC SIGNIFICANCE: This study extends prior research by examining the intersection of risk of mood and anxiety disorders and opioid use postpartum. Findings from this study support the need for future research to identify the drivers of increased opioid use among postpartum women with mood and anxiety disorders. (Am J Addict 2020;29:463-470).
BACKGROUND AND OBJECTIVES: Postpartum women represent a large population with opioid exposure who also have an increased risk of experiencing mood and anxiety disorders. However, the effect that mood and anxiety disorders have on opioid use postpartum has received little attention in the literature. Therefore, the objective of this study was to examine the association of mood and anxiety disorders with filling opioid prescriptions within the first 3 months postpartum. METHODS: A retrospective cohort study (n = 25 279) was completed using claims data for a sample of privately insured women who gave birth in the state of Iowa. The interactive effects of mood and anxiety disorders and delivery mode on filling at least one and two or more opioid prescriptions were examined in logistic regression models. RESULTS: The presence of mood and anxiety disorders among women who delivered vaginally increased their odds of filling at least one opioid fill by nearly 50% (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.35-1.63) and by 20% (OR: 1.20, 95% CI: 1.00-1.43) among women with cesarean delivery. DISCUSSION AND CONCLUSION: Postpartum women with mood and anxiety disorders were more likely to fill opioid prescriptions postpartum compared to women without these conditions. SCIENTIFIC SIGNIFICANCE: This study extends prior research by examining the intersection of risk of mood and anxiety disorders and opioid use postpartum. Findings from this study support the need for future research to identify the drivers of increased opioid use among postpartum women with mood and anxiety disorders. (Am J Addict 2020;29:463-470).
Authors: Ryan D Ross; Xu Shi; Megan E V Caram; Pheobe A Tsao; Paul Lin; Amy Bohnert; Min Zhang; Bhramar Mukherjee Journal: Health Serv Outcomes Res Methodol Date: 2020-10-20