Opioid use disorder and maternal outcomes following cesarean delivery: a multistate analysis, 2007-2014

J Comp Eff Res. 2020 Jul;9(10):667-677. doi: 10.2217/cer-2020-0050. Epub 2020 Jul 10.

Abstract

Aim: To examine the association between opioid use disorder (OUD) and maternal outcomes following cesarean delivery. Methods: Retrospective analysis of over 2.4 million discharge records for in-patient cesarean delivery across five states from 2007 to 2014. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS) and 30- and 90-day readmission rates. Results: OUD patients were 148% more likely than non-OUD patients to die during hospitalization (adjusted odds ratios [aOR]: 2.48, 95% CI: 1.20, 5.10; p < 0.05). OUD was associated with increased odds of 30-day readmission (aOR: 1.46, 95% CI: 1.30, 1.65; p < 0.001) and 90-day readmission (aOR: 1.70, 95% CI: 1.55, 1.88; p < 0.001); LOS was not significantly different. Conclusion: OUD predicts increased in-patient mortality and odds of 30- and 90-day readmission following cesarean delivery.

Keywords: cesarean delivery; health disparities; maternal outcomes; opioid use disorder; outcomes research.

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage*
  • Cesarean Section / adverse effects*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Maternal Mortality*
  • Opioid-Related Disorders / diagnosis*
  • Opioid-Related Disorders / epidemiology
  • Patient Discharge
  • Patient Readmission
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / psychology
  • Retrospective Studies

Substances

  • Analgesics, Opioid