CDC. US: More than a third of reproductive-aged women enrolled in Medicaid,
and more than a quarter of those with private insurance, filled a
prescription for an opioid pain medication each year during 2008-2012,
according to a report in this week’s Morbidity and Mortality Weekly
Report (MMWR).
Opioids are typically prescribed by health care
providers to treat moderate to severe pain. They are also found in some
prescription cough medications. The most commonly prescribed opioids
among both groups of women were hydrocodone, codeine and oxycodone.
“Taking
opioid medications early in pregnancy can cause birth defects and
serious problems for the infant and the mother,” said CDC Director Tom
Frieden, M.D., M.P.H. “Many women of reproductive age are taking these
medicines and may not know they are pregnant and therefore may be
unknowingly exposing their unborn child. That’s why it’s critical for
health care professionals to take a thorough health assessment before
prescribing these medicines to women of reproductive age.”
CDC
researchers analyzed 2008-2012 data from two large health insurance
claims datasets: one of women aged 15-44 years with private insurance
and another of women in the same age group enrolled in Medicaid. They
found that, on average, 39 percent of Medicaid-enrolled women filled an
opioid prescription from an outpatient pharmacy each year compared to 28
percent of women with private health insurance.
The higher
opioid prescribing rates among Medicaid enrollees might be due to
differences in the prescription medications covered under their health
insurance plan, differences in use of health care services, or
differences in the prevalence of underlying health conditions among
Medicaid enrollees compared with persons covered by private health
insurance.
Geographic region data available in the private
insurance claims indicated that opioid prescription rates were highest
among reproductive-aged women in the South and lowest in the Northeast.
Race/ethnicity information was available for the Medicaid data and
indicated opioid prescriptions were nearly one and a half times higher
among non-Hispanic white women of reproductive age compared to
non-Hispanic black or Hispanic women.
Previous studies of opioid
use in pregnancy suggest these medications might increase the risk of
neural tube defects (major defects of the baby’s brain and spine),
congenital heart defects and gastroschisis (a defect of the baby’s
abdominal wall). There is also a risk of neonatal abstinence syndrome
(NAS) from exposure to medications such as opioids in pregnancy. NAS is
when a newborn experiences symptoms of withdrawal from medications or
drugs taken by a mother during pregnancy.
“Women, who are
pregnant, or planning to become pregnant, should discuss with their
health care professional the risks and benefits for any medication they
are taking or considering.” said Coleen Boyle, Ph.D., MS.Hyg., Director
of CDC’s National Center on Birth Defects and Developmental
Disabilities. “This new information underscores the importance of
responsible prescribing, especially of opioids, for women of child
bearing age.”
CDC’s National Center on Birth Defects and
Developmental Disabilities is working to provide better information to
women and their health care providers about medication use during
pregnancy through its Treating for Two: Safer Medication Use in
Pregnancy initiative. Through Treating for Two, CDC is working with its
partners, other federal agencies and the public to understand trends in
medication use among pregnant women and women of childbearing age and
to provide women and health care providers with information about the
safety or risk of using specific medications during pregnancy. This
information will help women and their healthcare providers to make
informed decisions about treating health conditions during pregnancy.
For more information about medications and pregnancy, visit www.cdc.gov/pregnancymedication or www.cdc.gov/treatingfortwo. To learn more about CDC’s work on birth defects, visit www.cdc.gov/ncbddd/birthdefects/.