TY - JOUR
T1 - Opioid-related disorders among pregnant women with sickle cell disease and adverse pregnancy outcomes
AU - Darlington, Francis
AU - Acha, Benjamina Mbah
AU - Roshan, Tasha
AU - Ikeanyionwu, Charles
AU - Kutse, Seun
AU - Abajue, Uzoamaka
AU - Osazuwa, Billy
AU - Gomez, Ian
AU - Spooner, Kiara K.
AU - Salemi, Jason L.
AU - Dongarwar, Deepa
AU - Olaleye, Omonike A.
AU - Salihu, Hamisu M.
AU - Ndefo, Uche Anadu
N1 - Funding Information:
Funding sources: Research funding support was provided by the US Department of Health and Human Services, Health Resources and Services Administration for the Maternal and Child Health Pipeline Training Program: TSU-BCM Maternal and Child Health Student Training for Academic Readiness and Success (MCH STARS) Undergraduate Fellowship Program, Grant No. T16MC29831.
Publisher Copyright:
© 2020 The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Objective. Opioid use during pregnancy has increased in recent years, parallel with the opioid epidemic in the general population. Opioids are commonly used as an analgesic for pain crisis, a hallmark symptom of sickle cell disease (SCD). With the amplified frequency and severity of SCD pain crisis during pregnancy, the use of opioids may increase concurrently. The aim of this study was to examine trends in opioid-related disorders (ORDs) among pregnant women with and without SCD, as well as assess the risk for preterm labor, maternal sepsis, and poor fetal growth among patients with SCD and ORD. Methods. We conducted a retrospective analysis of inpatient pregnancyand childbirth-related hospital discharge data from the 2002-2014 National (Nationwide) Inpatient Sample database. The primary outcome was the risk of ORD in pregnant women with SCD and its impact on threatened preterm labor, fetal growth, and maternal sepsis. Results. Among the >57 million pregnancy-related hospitalizations examined, 9.6 per 10,000 had SCD. ORD in mothers with SCD was four times as prevalent as in those without SCD (2% vs 0.5%). A significant rise in ORD occurred throughout the study period and was associated with an increased risk of maternal sepsis, threatened preterm labor, and poor fetal growth. Conclusions. Pregnant women with SCD have a fourfold increased risk of ORD compared with their non-SCD counterparts. The current opioid epidemic continues to worsen in both groups, warranting a tailored and effective public health response to reduce the resulting adverse pregnancy outcomes.
AB - Objective. Opioid use during pregnancy has increased in recent years, parallel with the opioid epidemic in the general population. Opioids are commonly used as an analgesic for pain crisis, a hallmark symptom of sickle cell disease (SCD). With the amplified frequency and severity of SCD pain crisis during pregnancy, the use of opioids may increase concurrently. The aim of this study was to examine trends in opioid-related disorders (ORDs) among pregnant women with and without SCD, as well as assess the risk for preterm labor, maternal sepsis, and poor fetal growth among patients with SCD and ORD. Methods. We conducted a retrospective analysis of inpatient pregnancyand childbirth-related hospital discharge data from the 2002-2014 National (Nationwide) Inpatient Sample database. The primary outcome was the risk of ORD in pregnant women with SCD and its impact on threatened preterm labor, fetal growth, and maternal sepsis. Results. Among the >57 million pregnancy-related hospitalizations examined, 9.6 per 10,000 had SCD. ORD in mothers with SCD was four times as prevalent as in those without SCD (2% vs 0.5%). A significant rise in ORD occurred throughout the study period and was associated with an increased risk of maternal sepsis, threatened preterm labor, and poor fetal growth. Conclusions. Pregnant women with SCD have a fourfold increased risk of ORD compared with their non-SCD counterparts. The current opioid epidemic continues to worsen in both groups, warranting a tailored and effective public health response to reduce the resulting adverse pregnancy outcomes.
KW - Opioid
KW - Pregnancy
KW - Sickle Cell Disease
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U2 - 10.1093/PM/PNAA188
DO - 10.1093/PM/PNAA188
M3 - Article
C2 - 32710119
AN - SCOPUS:85101319731
SN - 1526-2375
VL - 21
SP - 3087
EP - 3093
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 11
ER -