CDC: Reduce Opioid Exposure Among Reproductive-Aged Women

Studies of opioid exposure in pregnancy suggest an increased risk for adverse pregnancy outcomes, including neonatal abstinence syndrome and birth defects (eg, neural tube defects, gastroschisis, and congenital heart defects). Birth defects often occur from opioid exposure during the first few weeks of pregnancy. Due to many unrecognized or unintended pregnancies in the United States, this risk affects all women who might become pregnant.

The Centers for Disease Control and Prevention (CDC) evaluated opioid prescriptions dispensed by outpatient pharmacies to women aged 15–44 years from 2008–2012. Claims of pure opioid antagonists (eg, naloxone) and drugs that block the effect of opioids not in combination with an opioid (eg, buprenorphine/naloxone) were excluded. About 39.4% of Medicaid-enrolled women and 27.7% of privately insured women filled an opioid prescription from an outpatient pharmacy each year (P<0.001). In general, opioid prescription claims were higher among Medicaid-enrolled women vs. privately insured during the 2008–2012 period.

Hydrocodone, codeine, and oxycodone were found to be the most frequently prescribed opioids among women in Medicaid-enrolled and privately insured women. Specifically, privately insured women aged 30–34 years and Medicaid-enrolled women aged 40–44 years were most likely to fill opioid prescriptions; women aged 15–19 years were least likely to fill an opioid prescription.

The study shows the need for more interventions to reduce opioid prescriptions among women of reproductive potential especially when safer alternatives are available or when opioid use is unnecessary. An improved understanding of prescription opioid use pre- and during early pregnancy can help directed interventions to reduce unnecessary prescribing and inform women about the risk of prenatal opioid exposure.

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