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Health Services Research & Development

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2015 HSR&D/QUERI National Conference Abstract

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3075 — Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care

Kroll-Desrosiers AR, UMass Medical School; VA Central Western Massachusetts; Skanderson M, VA Connecticut Healthcare System; Bastian LA, VA Connecticut Healthcare System; Brandt CA, VA Connecticut Healthcare System; Haskell S, VA Connecticut Healthcare System; Kerns RD, VA Connecticut Healthcare System; Mattocks KM, VA Central Western Massachusetts; UMass Medical School;

Objectives:
A growing number of reproductive-aged women veterans are returning from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND). In 2010, 42% of women veterans receiving Veterans Health Administration (VHA) services were aged 18-45. Prescription opioid use has increased among all veterans over the past decade; however, exposure among pregnant veterans has not been examined. Thus, our objectives were two-fold: 1) to understand the prevalence of opioid prescribing to pregnant veterans, and 2) to examine sociodemographic, service-connected, and mental and physical health factors associated with receiving a prescription for opioids during a 280-day pregnancy window.

Methods:
We identified 2,331 women with a delivery paid for by the VHA between 2001 and 2010. Delivery, opioid prescribing history, demographic and health-related variables were obtained from a national database of veterans receiving VHA services. Receipt of an opioid prescription was defined as any filled VHA prescription for opioids in the 280-day pregnancy window prior to delivery. We developed a multivariable logistic regression model adjusted for sociodemographic, service-related, and mental and physical health variables to examine the odds of filling an opioid prescription during the pregnancy window.

Results:
Ten percent of pregnant veterans received VA prescription opioids during their pregnancy window. Significant factors associated with opioid prescriptions included presence of any mental health condition (adjusted odds ratio [aOR]: 1.67; 95% CI: 1.24-2.26), diagnosis of back problems (aOR: 2.94; 95% CI: 1.92-4.49) or other non-traumatic joint disorders (aOR: 2.20; 95% CI: 1.36-3.58).

Implications:
This study suggests that a substantial proportion of women veterans received VA prescriptions for opioids during pregnancy.

Impacts:
Providers should be aware of the potential risks of prescription opioid use during pregnancy and consider alternate pain management strategies when possible.