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2015 HSR&D/QUERI National Conference Abstract

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;

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.

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.

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).

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

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