{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:24:34Z","timestamp":1787217874122,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While opioid use during pregnancy has raised concerns worldwide, population\u2010based data in Europe remain limited. In France, little is known about opioid use in the context of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide drug utilization study using the French EPI\u2010MERES Registry, derived from the National Health Data System (SNDS), including pregnancies \u2265\u200922\u2009weeks from 2010 to 2023. Exposure to weak and strong opioids was assessed before, during and after pregnancy, and according to calendar years. Exposure characteristics included the number of dispensations, prescriber type and oral morphine equivalents. Maternal sociodemographic and clinical characteristics associated with opioid exposure were analysed using multivariable logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 9.9 million pregnancies, 548,881 (5.5%) were exposed to weak opioids and 12,501 (0.13%) to strong opioids. Weak opioid exposure increased sharply until 2016 (+120%) before stabilizing; diverging trends were observed thereafter: codeine exposure declined to 3.6% in 2023, whereas tramadol exposure continued to rise (+170% during study period) reaching 2.5%. Opioid exposure substantially decreased after conception and remained low throughout pregnancy. Weak opioid prescriptions were not refilled across trimesters in 85%\u201395% of exposed pregnancies. Opioid exposure was positively associated with maternal socioeconomic deprivation, chronic diseases and psychiatric disorders, with stronger associations observed for strong opioids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In France, opioid use in the context of pregnancy is not infrequent and almost exclusively driven by short\u2010term use of weak opioids. It is strongly associated with maternal vulnerability and low\u2010income status. Although overall opioid exposure stabilized since 2016, the continuous rise in tramadol use warrants further monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Population\u2010based evidence on opioid use during pregnancy is scarce in Europe and has been lacking in France. This nationwide study provides the first comprehensive analysis of prescription opioid use in pregnancy in France over a 14\u2010year period, identifying prescribing patterns and populations most likely to be exposed. After a marked increase at the beginning of the study period, overall opioid exposure is stable. In the most recent years, one in 16 pregnant women is exposed to an opioid, almost exclusively a weak opioid,\u00a0and we observed a sustained rise in tramadol exposure throughout the study period. These findings establish a benchmark for future surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70333","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:14:41Z","timestamp":1785752081000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and Characteristics of Opioid Use During Pregnancy Between 2010 and 2023: A French Nationwide Drug Utilization Study"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9626-3571","authenticated-orcid":false,"given":"Laurent","family":"Chouchana","sequence":"first","affiliation":[{"name":"EPI\u2010PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance  Saint\u2010Denis France"},{"name":"Regional Center of Pharmacovigilance, Department of Perinatal, Pediatric and Adult 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