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A nation-wide Swedish study of opioid analgesic prescribing patterns during pregnancy and associated preexisting mental health conditions
Department of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.
Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA.
Department of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.
Department of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA.
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2022 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 35, no 25, p. 5161-5167Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Research has consistently shown individuals with mental health conditions are more likely to be prescribed opioid analgesic medications and to engage in heavier utilization. However, it is unclear whether these findings apply to pregnant women.

STUDY DESIGN: We explored opioid analgesic prescription in 689,400 pregnancies occurring in Sweden between 2007 and 2013. We investigated prescription patterns across time and type of source clinic for any opioid analgesic and for strong and weak opioid analgesics. We further evaluated the extent to which receipt of opioid analgesic medications was associated with previous mental health diagnoses and prescriptions of other psychoactive medications.

RESULTS: The prevalence of pregnant women who filled prescriptions for opioid analgesics (4.5%) was relatively stable across the assessed years. However, among pregnant women who filled opioid analgesic prescriptions, there was a large increase in strong opioid analgesic prescriptions-from 6.1% in 2007 to 17.1% in 2013. The main source of opioid analgesic prescriptions were primary care and obstetrics and gynecology clinics-38.7% of all filled prescriptions originated from primary care providers and 25.3% from obstetrics and gynecology practitioners. Compared to pregnant women who did not fill any opioid analgesic prescriptions, those who did were more likely to have a wide range of pre-existing mental health diagnoses (e.g., anxiety disorder odds ratio[OR] = 3.13, 95% confidence interval[CI]:2.98,3.29) and to utilize a wide range of other psychoactive medications (e.g., benzodiazepines OR =4.26, 95% CI:4.10,4.43). Similarly, those who received strong opioids were more likely to have a wide range of mental health diagnoses and be prescribed a wide range of psychoactive medications compared to those who received weak opioids.

CONCLUSIONS: These results highlight the need for physicians treating pregnant women and women of childbearing age for painful conditions to obtain detailed histories of mental health problems, screen for symptoms of mental health problems, and facilitate integrated care and evidence-based mental health interventions if needed.

Place, publisher, year, edition, pages
Informa Healthcare, 2022. Vol. 35, no 25, p. 5161-5167
Keywords [en]
Mental health, opioid analgesics, pregnancy, prenatal care, prenatal diagnosis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-88532DOI: 10.1080/14767058.2021.1875436ISI: 000627618700001PubMedID: 33441038Scopus ID: 2-s2.0-85102577163OAI: oai:DiVA.org:oru-88532DiVA, id: diva2:1518943
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 50623213Swedish Research Council, 2014-38313831 2018-02679
Note

Funding Agencies:

National Science Foundation (NSF) 1342962

United States Department of Health & Human Services

National Institutes of Health (NIH) - USA

NIH National Institute on Drug Abuse (NIDA) R01DA048042 R00DA040727

Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM) 340-2013-5867

Available from: 2021-01-18 Created: 2021-01-18 Last updated: 2023-12-08Bibliographically approved

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Larsson, Henrik

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