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Annals of internal medicine. 2020 Dec 1;173(11 Suppl):S19-S28. doi: 10.7326/M19-3249 Q119.62024

Trends in Opioid and Psychotropic Prescription in Pregnancy in the United States From 2001 to 2015 in a Privately Insured Population : A Cross-sectional Study

美国2001至2015年期间孕妇类阿片和精神活性药物处方趋势——一项针对私保人群的横断面研究 翻译改进

Kartik K Venkatesh  1, Virginia Pate  2, Kim A Boggess  3, Hendrée E Jones  3, Michele Jonsson Funk  2, Marcela C Smid  4

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作者单位

  • 1 The Ohio State University, Columbus, Ohio (K.K.V.).
  • 2 Gillings School of Global Public Health and Center for Women's Health Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (V.P., M.J.F.).
  • 3 University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (K.A.B., H.E.J.).
  • 4 University of Utah Health, Salt Lake City, Utah (M.C.S.).
  • DOI: 10.7326/M19-3249 PMID: 33253018

    摘要 Ai翻译

    Background: Opioid and psychotropic prescriptions are common during pregnancy. Little is known about coprescriptions of both medications in this setting.

    Objective: To describe opioid prescription among women who are prescribed psychotropics compared with women who are not.

    Design: Cross-sectional study.

    Setting: U.S. commercial insurance beneficiaries from MarketScan (2001 to 2015).

    Participants: Pregnant women at 22 weeks' gestation or greater who were insured continuously for 3 months or more before pregnancy through delivery.

    Measurements: Opioid prescription, dosage thresholds (morphine milligram equivalents [MME] of ≥50/day and ≥90/day), number of opioid agents (≥2), and duration (≥30 days) among those with and without prescription of psychotropics, from 2011 to 2015.

    Results: Among 958 980 pregnant women, 10% received opioids only, 6% psychotropics only, and 2% opioids with coprescription of psychotropics. Opioid prescription was higher among women prescribed psychotropics versus those who were not (26.5% vs. 10.7%). From 2001 to 2015, psychotropic prescription overall increased from 4.4% to 7.6%, opioid prescription without coprescription of psychotropics decreased from 11.9% to 8.4%, and opioids with coprescription decreased from 28.1% to 22.0%. Morphine milligram equivalents of 50 or greater per day decreased for women with and without coprescription (29.6% to 17.3% and 22.8% to 18.5%, respectively); MME of 90 or greater per day also decreased in both groups (15.0% to 4.7% and 11.5% to 4.2%, respectively). Women prescribed opioids only were more likely to have an antepartum hospitalization compared with those with neither prescription, as were women with coprescription versus those prescribed psychotropics only. Compared with those prescribed opioids only, women with coprescriptions were more likely to exceed MME of 90 or greater per day and to be prescribed 2 or more opioid agents and for 30 days or longer. Number and duration of opioids increased with benzodiazepine and gabapentin coprescription.

    Limitation: Inability to determine appropriateness of prescribing or overdose events.

    Conclusion: Opioids are frequently coprescribed with psychotropic medication during pregnancy and are associated with antepartum hospitalization. A substantial proportion of pregnant women are prescribed opioids at doses that increase overdose risk and exceed daily recommendations.

    Primary funding source: None.

    Keywords:opioid prescription; psychotropic prescription; pregnancy trends; united states

    Copyright © Annals of internal medicine. 中文内容为AI机器翻译,仅供参考!

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    期刊名:Annals of internal medicine

    缩写:ANN INTERN MED

    ISSN:0003-4819

    e-ISSN:1539-3704

    IF/分区:19.6/Q1

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    Trends in Opioid and Psychotropic Prescription in Pregnancy in the United States From 2001 to 2015 in a Privately Insured Population : A Cross-sectional Study