White Paper - Drug Use During Pregnancy

Aeon Participates In Groundbreaking Research On Drug Use By Pregnant Women

Shona L. Ray-Griffith, M.D.1,2; Jessica Coker, M.D.1; Shawn Desai, Ph.D., J.D.3; Xiaotong Han1; Zachary N. Stowe, M.D.1,2,4
1 Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
2 Department of Obstetrics &Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
3 AEON Clinical Laboratories, Atlanta, GA
4 Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Objective

Recent studies have demonstrated that up to 14% of women receive an opioid prescription during pregnancy. The majority of antepartum opioid exposure is not related to abuse, but could be influenced by psychiatric co-morbidity. The interaction between depression and pain during pregnancy has not been well examined. This study examines psychiatric diagnoses and symptoms associated with antepartum analgesic use.

Methods

Cases and samples were extracted from a prospective biorepository/database of women with neuropsychiatric illnesses over the pregnancy and postpartum periods. Study procedures include: SCID, medication tracking form, clinician- and self-rated symptom scales, and urine collection at 4-8 week intervals. Inclusion criteria for analyses included enrollment prior to 32 weeks gestation, > 17 years old, and 3rd trimester urine assays. Analgesic medications were grouped as acetaminophen, NSAIDS, opioids, tricyclic antidepressants, and anti-epileptic drugs. Weekly medication tracking was compared to the comprehensive urine medication/drug panel from AEON labs. The association of maternal life-time psychiatric diagnosis and depressive symptoms across pregnancy with the use of analgesics is under examination.

Results

A total of 784 women were analyzed. Notably, 27% were positive for acetaminophen; 10.5% for opioids; and 3% for anti-epileptic drugs. Examination of the association between diagnosis and exposure are underway.

Conclusions

The treatment of pain during pregnancy poses a challenge secondary to limited safety data on most interventions. The effective treatment of depression may reduce analgesic exposure, and analgesic exposure needs to be incorporated in maternal neuropsychiatric outcome studies.