Trends in Prenatal Prescription Opioid Use Among Medicaid Beneficiaries in Wisconsin, 2010-2019

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2024 Apr 1

PMID 38561393

Authors

Deborah B Ehrenthal

Yi Wang

Jessica Pac

Christine Piette Durrance

Russell S Kirby

Lawrence M Berger

Affiliations

Soon will be listed here.

Abstract

Objective: To examine changes in prenatal opioid prescription exposure following new guidelines and policies.

Study Design: Cohort study of all (262,284) Wisconsin Medicaid-insured live births 2010-2019. Prenatal exposures were classified as analgesic, short term, and chronic (90+ days), and medications used to treat opioid use disorder (MOUD). We describe overall and stratified temporal trends and used linear probability models with interaction terms to test their significance.

Result: We found 42,437 (16.2%) infants with prenatal exposure; most (90.5%) reflected analgesic opioids. From 2010 to 2019, overall exposure declined 12.8 percentage points (95% CI = 12.1-13.1). Reductions were observed across maternal demographic groups and in both rural and urban settings, though the extent varied. There was a small reduction in chronic analgesic exposure and a concurrent increase in MOUD.

Conclusion: Broad and sustained declines in prenatal prescription opioid exposure occurred over the decade, with little change in the percentage of infants chronically exposed.

Citing Articles

Distinct Trajectories of Prescription Opioid Exposure in Pregnancy and Risk of Adverse Birth Outcomes.

Wang Y, Ehrenthal D, Zhang L J Addict Med. 2024; 19(1):53-61.

PMID: 39221831 PMC: 11790364. DOI: 10.1097/ADM.0000000000001374.

References

Haegerich T, Jones C, Cote P, Robinson A, Ross L . Evidence for state, community and systems-level prevention strategies to address the opioid crisis. Drug Alcohol Depend. 2019; 204:107563. PMC: 9286294. DOI: 10.1016/j.drugalcdep.2019.107563. View

Haight S, Ko J, Tong V, Bohm M, Callaghan W . Opioid Use Disorder Documented at Delivery Hospitalization - United States, 1999-2014. MMWR Morb Mortal Wkly Rep. 2018; 67(31):845-849. PMC: 6089335. DOI: 10.15585/mmwr.mm6731a1. View

Schieber L, Guy Jr G, Seth P, Young R, Mattson C, Mikosz C . Trends and Patterns of Geographic Variation in Opioid Prescribing Practices by State, United States, 2006-2017. JAMA Netw Open. 2019; 2(3):e190665. PMC: 6484643. DOI: 10.1001/jamanetworkopen.2019.0665. View

Bateman B, Hernandez-Diaz S, Rathmell J, Seeger J, Doherty M, Fischer M . Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States. Anesthesiology. 2014; 120(5):1216-24. PMC: 3999216. DOI: 10.1097/ALN.0000000000000172. View

Hirai A, Ko J, Owens P, Stocks C, Patrick S . Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017. JAMA. 2021; 325(2):146-155. PMC: 7804920. DOI: 10.1001/jama.2020.24991. View

Rebbe R, Mienko J, Brown E, Rowhani-Rahbar A . Hospital Variation in Child Protection Reports of Substance Exposed Infants. J Pediatr. 2019; 208:141-147.e2. PMC: 6486842. DOI: 10.1016/j.jpeds.2018.12.065. View

Martin J, Osterman M, Kirmeyer S, Gregory E . Measuring Gestational Age in Vital Statistics Data: Transitioning to the Obstetric Estimate. Natl Vital Stat Rep. 2015; 64(5):1-20. View

Prindle J, Hammond I, Putnam-Hornstein E . Prenatal substance exposure diagnosed at birth and infant involvement with child protective services. Child Abuse Negl. 2017; 76:75-83. DOI: 10.1016/j.chiabu.2017.10.002. View

Desai R, Hernandez-Diaz S, Bateman B, Huybrechts K . Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstet Gynecol. 2014; 123(5):997-1002. PMC: 4020039. DOI: 10.1097/AOG.0000000000000208. View

10.

Pac J, Durrance C, Berger L, Ehrenthal D . The Effects of Opioid Use during Pregnancy on Infant Health and Well-Being. Ann Am Acad Pol Soc Sci. 2023; 703(1):106-138. PMC: 10552918. DOI: 10.1177/00027162231154338. View

11.

Basco Jr W, McCauley J, Zhang J, Mauldin P, Simpson K, Heidari K . Trends in Dispensed Opioid Analgesic Prescriptions to Children in South Carolina: 2010-2017. Pediatrics. 2021; 147(3). PMC: 7924141. DOI: 10.1542/peds.2020-0649. View

12.

Dude C, Jamieson D . Assessment of the Safety of Common Medications Used During Pregnancy. JAMA. 2021; 326(23):2421-2422. DOI: 10.1001/jama.2021.20191. View

13.

Austin A, Di Bona V, Cox M, Proescholdbell S, Fliss M, Naumann R . Prenatal Use of Medication for Opioid Use Disorder and Other Prescription Opioids in Cases of Neonatal Opioid Withdrawal Syndrome: North Carolina Medicaid, 2016-2018. Am J Public Health. 2021; 111(9):1682-1685. PMC: 8589053. DOI: 10.2105/AJPH.2021.306374. View

14.

Renny M, Shonna Yin H, Jent V, Hadland S, Cerda M . Temporal Trends in Opioid Prescribing Practices in Children, Adolescents, and Younger Adults in the US From 2006 to 2018. JAMA Pediatr. 2021; 175(10):1043-1052. PMC: 8240008. DOI: 10.1001/jamapediatrics.2021.1832. View

15.

Wen H, Hockenberry J, Jeng P, Bao Y . Prescription Drug Monitoring Program Mandates: Impact On Opioid Prescribing And Related Hospital Use. Health Aff (Millwood). 2019; 38(9):1550-1556. PMC: 6824582. DOI: 10.1377/hlthaff.2019.00103. View

16.

. ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy. Obstet Gynecol. 2012; 119(5):1070-6. DOI: 10.1097/AOG.0b013e318256496e. View

17.

Ingram D, Franco S . 2013 NCHS Urban-Rural Classification Scheme for Counties. Vital Health Stat 2. 2014; (166):1-73. View

18.

Krans E, Patrick S . Opioid Use Disorder in Pregnancy: Health Policy and Practice in the Midst of an Epidemic. Obstet Gynecol. 2016; 128(1):4-10. PMC: 4917415. DOI: 10.1097/AOG.0000000000001446. View

19.

Rebbe R, Mienko J, Brown E, Rowhani-Rahbar A . Child protection reports and removals of infants diagnosed with prenatal substance exposure. Child Abuse Negl. 2018; 88:28-36. PMC: 6333477. DOI: 10.1016/j.chiabu.2018.11.001. View

20.

Sujan A, Rickert M, Quinn P, Ludema C, Wiggs K, Larsson H . A population-based study of concurrent prescriptions of opioid analgesic and selective serotonin reuptake inhibitor medications during pregnancy and risk for adverse birth outcomes. Paediatr Perinat Epidemiol. 2020; 35(2):184-193. PMC: 7878346. DOI: 10.1111/ppe.12721. View