Incidence of persistent postpartum opioid use by mode of delivery: a 2016 cohort study of Danish women.

BACKGROUND: The use of oral opioids as standard treatment after cesarean delivery has been linked to persistent use in opioid-naïve women in the USA. In Denmark, the use of opioids after cesarean delivery is typically restricted to in-hospital use. The aim of this study was to estimate the incidence of persistent postpartum opioid use in Denmark and compare the incidence by mode of delivery. METHODS: This was a national cohort study of all women giving birth in Denmark in 2016, with one-year follow-up. Data from Danish registries were retrieved and combined using each woman's unique identification number. Persistent use of opioids was defined as ≥3 redeemed opioid prescriptions 31-365 days postpartum. RESULTS: A total of 62 520 births were included in the cohort: 49 859 vaginal deliveries, 5310 intrapartum cesarean deliveries, and 7351 pre-labor cesarean deliveries. For all births, persistent postpartum opioid use occurred in 85 (140 in 100 000) women of whom 36 (42%) had opioid use during pregnancy. The incidence of persistent opioid use was highest in the pre-labor cesarean delivery cohort (n=27; 360 in 100 000) and lowest in the intrapartum cesarean delivery cohort (n=3, 60 in 100 000; P<0.001). Women taking opioids during pregnancy were at increased risk of persistent opioid use (odds ratio 63.3; 95% CI 43.9 to 91.4). CONCLUSIONS: Women giving birth in Denmark, where use of post-discharge opioid treatment is generally restricted, have a low risk of developing persistent use of opioids, with very few women seeking additional analgesic treatment from their general practitioner.

[Contraceptive habits among women applying for abortion]. / Praeventionsmønster blandt abortsøgende kvinder.

A total of 589 women applying for termination of pregnancy (46% of the total number of applicants during a one-year period) completed a questionnaire concerning female anatomy, sexual information and contraceptive habits. Of these, 415 women had their pregnancy terminated at Hvidovre Hospital, Copenhagen (high abortion rate) and 174 in northern Jutland (low abortion rate). The two groups did not differ considerably in their replies. Mean age at the first coitus was on average 15.8 years, where a total of 36% had not used any contraception. Among those who were applying for termination of pregnancy, 34.1% had not used contraception, 13.4% had used unsafe methods and 23% had not used the method correctly, leaving a total of 60% at high risk of pregnancy. Information about contraception was in most cases given by the general practitioner (38%). An increased number of women with a high level of sexual knowledge from Copenhagen had less frequently used contraception as compared with those in Jutland. In conclusion the high discrepancy in abortion rate among the two areas can not be explained by differences in contraceptive habits.