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Clinical Research

The association of obesity with post-cesarean inpatient opioid consumption

International Journal of Obesity volume 48, pages 370–375 (2024)Cite this article

Subjects

Abstract

Background

Obesity and prescription opioid misuse are important public health concerns in the United States. A common intersection occurs when women with obesity undergo cesarean birth and receive narcotic medications for postpartum pain.

Objective

To examine the association between obesity and inpatient opioid use after cesarean birth.

Methods

A retrospective cohort study of patients that underwent cesarean birth in 2015–2018. Primary outcome was post-cesarean delivery opioid consumption starting 24 h after delivery measured as morphine milliequivalents per hour (MME/h). Secondary outcome was MME/h consumption in the highest quartile of all subjects. Opioid consumption was compared between three BMI groups: non-obese BMI 18.5–29.9 kg/m2; obese BMI 30.0–39.9 kg/m2; and morbidly obese BMI ≥ 40.0 kg/m2 using univariable and multivariable analyses.

Results

Of 1620 patients meeting inclusion criteria, 496 (30.6%) were in the non-obese group, 753 (46.5%) were in the obese group, and 371 (22.9%) were in the morbidly obese group. In the univariate analysis, patients with obesity and morbid obesity required higher MME/h than patients in the non-obese group [1.3 MME/h (IQR 0.1, 2.4) vs. 1.6 MME/h (IQR 0.5, 2.8) vs. 1.8 MME/h (IQR 0.8, 2.9), for non-obese, obese, and morbidly obese groups respectively, p < 0.001]. In the multivariable analysis, this association did not persist. In contrast, subjects in the obese and morbidly obese groups were more likely to be in the highest quartile of MME/h opioid consumption compared with those in the non-obese group (23.5% vs. 48.1% vs. 28.4%, p < 0.001, respectively); with aOR 1.42 (95% CI 1.07–1.89, p = 0.016) and aOR 1.60 (95% CI 1.16–2.22, p = 0.005) for patients with obesity and morbid obesity, respectively.

Conclusion

Maternal obesity was not associated with higher hourly MME consumption during inpatient stay after cesarean birth. However, patients with obesity and morbid obesity were significantly more likely to be in the top quartile of MME hourly consumption.

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Data availability

All data generated or analyzed during this study are included in this published article.

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Author notes

  1. Rachel K. Harrison

    Present address: Advocate Medical Group Department of Maternal-Fetal Medicine, 4400 W. 95th St, Suite 207, Oak Lawn, IL, 60453, USA

Authors and Affiliations

  1. Department of Obstetrics and Gynecology at Medical College of Wisconsin, Milwaukee, WI, USA

    Abigail L. Strong, Alina Tvina, Rachel K. Harrison, Jayla Watkins, Esha Afreen, Shirng-Wern Tsaih & Anna Palatnik

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Contributions

ALS was responsible for designing the research idea, writing the protocol for the institutional review board, conducting the chart review, and writing the manuscript. AT contributed to interpreting the results, conducting literature review, updating references and drafting the manuscript. RKH was responsible for study design, writing the protocol and manuscript creation. JW and EA were responsible for data collection, table formation and revising the manuscript. SWT oversaw the study design, data analysis and table formation. AP supervised the study, data collection, analysis of data and revised the final manuscript.

Corresponding author

Correspondence to Alina Tvina.

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The authors declare no competing interests.

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Findings of this study were presented at the Society of Maternal Fetal Medicine’s 41st Annual Pregnancy Virtual Meeting on January 25–30, 2021.

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Strong, A.L., Tvina, A., Harrison, R.K. et al. The association of obesity with post-cesarean inpatient opioid consumption. Int J Obes 48, 370–375 (2024). https://doi.org/10.1038/s41366-023-01424-z

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