Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care
Department of Quantitative Health Sciences
Health Services Administration | Health Services Research | Maternal and Child Health | Psychiatric and Mental Health | Psychiatry and Psychology | Women's Health
BACKGROUND: A growing number of reproductive-age women veterans are returning from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND). In 2010, 42% of women veterans receiving Veterans Health Administration (VHA) services were aged 18 to 45. Prescription opioid use has increased among all veterans over the past decade; however, exposure among pregnant veterans has not been examined.
METHODS: We identified 2,331 women who delivered babies within the VHA system between 2001 and 2010. Delivery, opioid prescribing history, and demographic and health-related variables were obtained from a national database of veterans receiving VHA services. Receipt of an opioid prescription was defined as any filled VHA prescription for opioids in the 280-day pregnancy window before delivery. We developed a multivariable logistic regression model adjusted for sociodemographic, service-related, psychiatric diagnosis, and physical health variables to examine the odds of filling an opioid prescription during the pregnancy window.
FINDINGS: Ten percent of pregnant veterans received VHA prescription opioids during their pregnancy window. Significant factors associated with opioid prescriptions included presence of any psychiatric diagnosis (adjusted odds ratio [aOR], 1.67; 95% CI, 1.24-2.26), diagnosis of back problems (aOR, 2.94; 95% CI, 1.92-4.49), or other nontraumatic joint disorders (aOR, 2.20; 95% CI, 1.36-3.58).
CONCLUSIONS: This study suggests that a substantial proportion of women veterans received VHA prescriptions for opioids during pregnancy. Providers should be aware of the potential risks of prescription opioid use during pregnancy, assess for potential undertreatment of psychiatric diagnoses, and consider alternate pain management strategies when possible.
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Citation: Womens Health Issues. 2016 Mar-Apr;26(2):240-6. doi: 10.1016/j.whi.2015.09.010. Epub 2015 Nov 6. Link to article on publisher's site
Kroll-Desrosiers, Aimee; Skanderson, Melissa; Bastian, Lori; Brandt, Cynthia A.; Haskell, Sally; Kerns, Robert; and Mattocks, Kristin M., "Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care" (2016). University of Massachusetts Medical School Faculty Publications. 866.