{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:27:52Z","timestamp":1730870872877,"version":"3.28.0"},"reference-count":7,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to describe opioid prescribing patterns for pregnant patients with a history of or active opioid use to inform postpartum pain management strategies.<\/jats:p><jats:p>\n            Study Design\u2003We conducted a retrospective cohort analysis of all patients with a history of opioid use disorder (OUD) or chronic pain seen at a single outpatient clinic specializing in opioid use and OUD in pregnancy from January 2019 to August 2021. Patient characteristics, delivery outcomes, and opioid prescribing information were collected through electronic health record fields. We used descriptive statistics to characterize differences in receipt of an opioid prescription, prescription size, and receipt of a prescription refill across three patient groups: patients with OUD on medication, patients with OUD maintaining abstinence, and patients with chronic pain using opioids. In the study period, the institutional average rate of opioid prescribing after cesarean and vaginal birth were 80.0 and 2.8%, respectively.<\/jats:p><jats:p>\n            Results\u2003Of the 69 patients included in this study, 46 (66.7%) had a history of OUD on medication, 14 (20.3%) had a history of OUD maintaining abstinence, and 9 (13.0%) had a history of chronic pain. Receipt of an opioid prescription after childbirth was more common after cesarean birth (12\/23, 52.2%) than vaginal birth (3\/46, 6.5%). Refills were common in patients who received an opioid proscription (cesarean: 5\/12, 41.7%; vaginal: 1\/3, 33.3%).<\/jats:p><jats:p>\n            Conclusion\u2003Compared with institutional averages, postpartum opioid prescribing rates for people with a history of OUD or chronic pain were 50 to 60% lower for cesarean birth and three times higher for vaginal birth. Future work is needed to balance opioid stewardship and harm reduction with adequate pain control in these high-risk populations.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1767816","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T22:36:40Z","timestamp":1681166200000},"page":"e1459-e1462","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Postpartum Opioid Prescribing in Patients with Opioid Use Prior to Birth"],"prefix":"10.1055","volume":"41","author":[{"given":"Alex F.","family":"Peahl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan"},{"name":"Department of Obstetrics and Gynecology, Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Keer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Hallway","sequence":"additional","affiliation":[{"name":"Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan"},{"name":"Michigan Surgical Quality Collaborative, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke","family":"Kenney","sequence":"additional","affiliation":[{"name":"Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer F.","family":"Waljee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, Michigan"},{"name":"Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan"},{"name":"Department of Surgery, University of Michigan, Ann Arbor, Michigan"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Townsel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"},{"name":"Department of Obstetrics and Gynecology, Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"117.e1","DOI":"10.1016\/j.ajog.2019.04.030","article-title":"Better late than never: why obstetricians must implement enhanced recovery after cesarean","volume":"221","author":"A F Peahl","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"353.e1","DOI":"10.1016\/j.ajog.2016.03.016","article-title":"Persistent opioid use following cesarean delivery: patterns and predictors among opioid-na\u00efve women","volume":"215","author":"B T Bateman","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"e197863","DOI":"10.1001\/jamanetworkopen.2019.7863","article-title":"Rates of new persistent opioid use after vaginal or cesarean birth among US women","volume":"2","author":"A F Peahl","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1097\/AOG.0000000000002235","article-title":"Committee opinion no. 711: opioid use and opioid use disorder in pregnancy","volume":"130","author":"American College of Obstetricians and Gynecologists","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"e170504","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"C M Brummett","year":"2017","journal-title":"JAMA Surg"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1097\/AOG.0000000000002789","article-title":"Implementation of a quality improvement initiative to decrease opioid prescribing after cesarean delivery","volume":"132","author":"M Prabhu","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1097\/AOG.0000000000003512","article-title":"Decreasing opioid use postpartum: a quality improvement initiative","volume":"134","author":"R G Rogers","year":"2019","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1767816.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:50:40Z","timestamp":1730814640000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1767816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,10]]},"references-count":7,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1767816","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published":{"date-parts":[[2023,4,10]]}}}