Abstract:
OBJECTIVE:To estimate the prevalence of filled opioid prescriptions after vaginal delivery. METHODS:We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy. Outcomes included a binary measure of whether a woman had any opioid prescription fill 5 days or less after delivery and, among those women, a second opioid prescription fill 6-60 days after delivery. Among women with no coded pain-inducing conditions at delivery, we used multivariable logistic regression with standard errors clustered to account for within-hospital correlation to assess the association between patient characteristics and odds of a filled opioid prescription. RESULTS:Twelve percent of women (n=18,131) filled an outpatient opioid prescription 5 days or less after vaginal delivery; among those women, 14% (n=2,592, or 1.6% of the total) filled a second opioid prescription 6-60 days after delivery. Of the former, 5,110 (28.2%) had one or more pain-inducing conditions. Predictors of filled opioid prescriptions with no observed pain-inducing condition at delivery included tobacco use (adjusted odds ratio [OR] 1.3, 95% confidence interval [CI] 1.2-1.4) and a mental health condition (adjusted OR 1.3, 95% CI 1.2-1.4). Having a diagnosis of substance use disorder other than opioid use disorder was not associated with filling an opioid prescription 5 days or less after delivery, but was associated with having a second opioid prescription 6-60 days after delivery (adjusted OR 1.4, 95% CI 1.2-1.6). CONCLUSION:More than 1 in 10 Medicaid-enrolled women fill an outpatient opioid prescription after vaginal delivery. National opioid-prescribing recommendations for common obstetrics procedures such as vaginal delivery are warranted.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Jarlenski M,Bodnar LM,Kim JY,Donohue J,Krans EE,Bogen DLdoi
10.1097/AOG.0000000000001868subject
Has Abstractpub_date
2017-03-01 00:00:00pages
431-437issue
3eissn
0029-7844issn
1873-233Xpii
00006250-201703000-00005journal_volume
129pub_type
杂志文章abstract::Studied was the peripheral bone density of 39 women (ages 18 to 43) with the diagnosis of secondary amenorrhea in an effort to define the population of amenorrheic women at risk for osteoporosis. Eight women had exercise-induced amenorrhea (athletes), 20 women had amenorrhea associated with weight loss, and 11 women h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Gestational alloimmune liver disease, a form of profound liver failure in the newborn, is the main underlying cause of the entity formerly known as neonatal hemochromatosis. Antepartum maternal intravenous immunoglobulin (IVIG) has been shown to prevent gestational alloimmune liver disease, which otherwise h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001569
更新日期:2016-11-01 00:00:00
abstract::Previous reports suggest an association between maternal serum complement component (C3 and C4) levels and perinatal outcome. Eighteen women with systemic lupus erythematosus (21 pregnancies) were prospectively studied. C3 and C4 levels were measured monthly unless more frequent data were needed for acute medical mana...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:To investigate vascular reactivity in women's cerebral arteries from reproductive age to postmenopause. METHODS:The pulsatility index (PI) was measured cross-sectionally in the internal carotid and middle cerebral arteries of 120 women, using a Doppler ultrasound system. Fifteen women were enrolled in each o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00119-6
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To evaluate whether there was a change in prevalence of human papillomavirus (HPV) in the United States correlated with the introduction of HPV vaccines in both vaccinated and unvaccinated women. METHODS:We performed a retrospective review of prevalence data for women aged 18-29 years living in the United St...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001760
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:To report our experience with the prenatal diagnosis of hepatic calcification. METHODS:Routine ultrasonography was done in 24,600 consecutive pregnancies of 14-26 weeks' gestation. Detailed sonographic studies, amniocenteses, and chromosomal, bacteriologic, virologic, and serologic investigations were perfor...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00278-Y
更新日期:1995-11-01 00:00:00
abstract::The danger to the newborn inherent in a postmature pregnancy has gained recognition. However, the diagnosis of postmaturity remains a difficult problem. The thromboplastic activity of amniotic fluid (TAAF) increases with the gestational age. Based on this phenomenon, the TAAF of 45 women in the 41st to 43rd weeks of g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-04-01 00:00:00
abstract::The authors report on the incidence of translocations detected among 300 Greek couples referred for cytogenetic investigation because of repeated abortion, stillbirth, and/or the birth of children with multiple congenital anomalies. Translocations were detected in 16 cases, ie, 1 of 19 couples. However, the incidence ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:To identify factors associated with post-term birth and factors associated with adverse outcomes in post-term births. METHODS:The sample was a 10-year cohort (1978-1987) of term (n = 379,445) and post-term (n = 65,796) births from the Medical Birth Registry of Norway. Gestational age was based on mothers' re...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00049-5
更新日期:1997-04-01 00:00:00
abstract::Two hundred women were studied in a randomized controlled trial of induction of labor using high-dose (3 mg) or low-dose (0.5 mg) prostaglandin E2 vaginal pessaries. Induction using 3-mg pessaries was more successful, with a shorter overall induction-delivery interval and less requirement for analgesia, although uteri...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::In a randomized, double-blind clinical trial, 208 women who underwent abdominal hysterectomy received either cefazolin (N = 108) or moxalactam (N = 100) as perioperative antimicrobial prophylaxis. There were no differences between the two groups in rates of serious infection, minor wound infection, standard febrile mo...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Because of donor oocyte programs, women who previously were considered too old to successfully achieve conception and delivery can now bear children. To our knowledge, there have been no previous reports of pregnancy outcome in women over age 50 who conceived using donor oocytes. This study presents the preg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To determine whether opinions and practice patterns have markedly changed over the past decade and whether clinicians are cognizant of the new ACOG definitions for forceps deliveries. METHODS:Two hundred ninety-five United States and Canadian residency programs were surveyed via a questionnaire; 203 (69%) re...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To survey the interest of obstetrician-gynecologists in serving as primary care physicians and their perceived preparedness for that role from the view points of managed care plans and obstetrician-gynecologists. METHODS:A sample of obstetrician-gynecologists was asked to describe their preferred physician r...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(97)00224-X
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of an integrated multiple risk intervention, delivered mainly during pregnancy, in reducing such risks (cigarette smoking, environmental tobacco smoke exposure, depression, and intimate partner violence) postpartum. METHODS:Data from this randomized controlled trial were collected pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AOG.0b013e3181834b10
更新日期:2008-09-01 00:00:00
abstract::Cecal volvulus in pregnancy is an uncommon complication. A case is reported of a 28-year-old white female, gravida 2, para 1, who presented at 36 weeks' gestation with flu-like symptoms accompanied by regular uterine contractions every 3 minutes; she underwent repeat cesarean section without incident. The patient did ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVE:To examine recurrent preterm birth and early term birth in women's initial and immediately subsequent pregnancies. METHODS:This retrospective cohort study included 163,889 women who delivered their first and second liveborn singleton neonates between 20 and 44 weeks of gestation in California from 2005 throu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001506
更新日期:2016-08-01 00:00:00
abstract::Twenty-one subjects with pregnancy-induced hypertension were investigated with regard to the relationship between maternal hemodynamics and fetal growth. Five of the infants were small for gestational age (SGA) (less than tenth percentile) and 16 were appropriate for gestational age (AGA) (greater than tenth percentil...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract::The presence of diffuse abdominal calcification in patients with known carcinoma is usually a sign of metastatic involvement. This finding in some patients who have been treated with high dosage radiation therapy may represent areas of tumor necrosis and subsequent healing without evidence of active malignancy. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To compare resistance index (RI) and pulsatility index (PI) in the spiral and intervillous arteries, and peak systolic velocity of the continuous intervillous flow in normal and abnormal first-trimester pregnancy. METHODS:Transvaginal color and pulsed Doppler were used in a prospective analysis of 60 normal ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/S0029-7844(96)00422-X
更新日期:1997-02-01 00:00:00
abstract::A case of fetal bradycardia associated with severe maternal hypothermia (92.9F) is reported. Until maternal temperature was corrected, the baseline fetal heart rate (FHR) remained between 90-110 beats per minute without other evidence of fetal distress and despite normal maternal blood pressure and pulse. With rewarmi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::The interactions of an antiestrogen (tamoxifen) and a progestin (medroxyprogesterone acetate) on endometrial 17 beta-hydroxysteroid dehydrogenase activities were studied in short-term experiments (four to 96 hours) in normally menstruating women at the follicular phase and were related to simultaneously measured conce...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVE:To determine the fetal response to and safety of maximal maternal exercise in the third trimester. METHODS:Twenty-three active women with uncomplicated pregnancies (singleton gestations) underwent maximal exercise testing in late gestation using a progressive maximal cycle ergometer protocol. Fetal heart rat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00940-6
更新日期:2000-10-01 00:00:00
abstract::We studied 30 control women and 131 pill users to evaluate effects of birth control pills and clinical factors on hemostasis. When control patients were matched with an equal number of pill users, none of the direct markers of activated hemostasis (fibrinopeptide A, platelet factor 4, and beta thromboglobulin) were in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To compare the effects of single and repeated courses of corticosteroids on brain growth in fetal sheep. METHODS:Pregnant sheep were given intramuscular betamethasone (0.5 mg/kg) at 104 days' gestation followed at 111, 118, and 124 days by equivalent volumes of sterile normal saline (n = 12) or betamethasone...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00265-3
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To assess the risks of congenital varicella syndrome and other birth defects in offspring of women who inadvertently received varicella vaccine during pregnancy or within 3 months of conception. METHODS:Pregnant women inadvertently exposed to varicella vaccine, reported voluntarily, were enrolled in the Preg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01384-9
更新日期:2001-07-01 00:00:00
abstract::Ultrasonic measurement of fetal chest circumference was tested as a predictor of pulmonary hypoplasia in a group of 26 fetuses at known risk. A 42% prevalence of autopsy-proved pulmonary hypoplasia was found in this population. Chest circumference measurements were plotted on published nomograms based upon head circum...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract::The inability to make a definitive diagnosis in the fetus with a sonographically identified abnormality often results in parental and physician uncertainty. An antenatal chromosome evaluation could resolve this uncertainty. Forty-one fetuses with an abnormal ultrasound examination were tested for karyotypic abnormalit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::A case of a rare association between pregnancy and the development of Cushing's syndrome is discussed. A 29-year-old woman developed Cushing's syndrome, characterized by hypokalemia, a high level of urinary 17-hydroxycorticoids not suppressed by dexamethasone therapy, a high level of plasma 11-hydroxycorticoids which...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1971-12-01 00:00:00
abstract:OBJECTIVE:To characterize the rate of obstetric anal sphincter injuries and identify key risk factors of obstetric anal sphincter injuries, including duration of the second stage of labor. METHODS:This retrospective cohort study included all singleton, term, cephalic vaginal deliveries within Kaiser Permanente Norther...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002444
更新日期:2018-02-01 00:00:00