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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Clinical Obstetrics

Poster Session 4

(1033) Postpartum Pain Scores in Patients Maintained on Medication for Opioid Use Disorder (MOUD)

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
To determine the frequency of severe postpartum pain in patients with OUD maintained on methadone and buprenorphine.

Study Design:
This was a single-center retrospective cohort study of women with a history of OUD on MOUD who presented for prenatal care or delivery between January 2017 to July 2023. Patient, pregnancy, and delivery outcomes were abstracted. High dose MOUD was defined as buprenorphine >16mg and methadone >100mg. Patients were compared based on their MOUD. The primary outcome was the number of times a severe pain score (score of 7 or greater on a 10-point scale) was reported from delivery to discharge.  Statistical analyses were performed by Mann-Whitney U Test, chi-square test, and multivariate logistic regression, with significance determined as p< 0.05.

Results:
419 women were included in the study. Compared to buprenorphine, more patients on methadone had not initiated prenatal care in the first trimester (p=0.004), had active drug use (p=< 0.001), polysubstance use (p< 0.001), required a high dose of MOUD (p< 0.001) and increase on MOUD (p< 0.001) dose at delivery (Table 1). MOUD was not associated with a difference in postpartum pain scores across all timepoints (Figure 1), and was not an independent predictor of severe pain scores. Polysubstance abuse was an independent predictor of severe pain scores at any point postpartum (aOR 2.0, 95%CI [1.3-3.2], p-value=0.04). Psychiatric medication use was an independent predictor of severe pain scores on PPD#0 (aOR 1.65, 95%CI [1.1-2.5], p-value=0.016). Both polysubstance use (aOR 1.9, 95%CI [1.2-3.0], p-value=0.03) and psychiatric medication use (aOR 1.5, 95%CI [1.0-2.3], p-value=0.047) were independent predictors for severe pain scores on PPD#2.

Conclusion:
While MOUD does not influence the severity of postpartum pain, differences in comorbid factors—such as polysubstance use and psychiatric medication use—may impact pain experiences.