The pharmacogenetics of opioid therapy in the management of postpartum pain: a systematic review

Abstract

Aims: Opioids are commonly prescribed for postpartum pain. Yet, providing adequate pain relief, while ensuring that the mother and her breastfeeding infant are protected from adverse events can be challenging. The objective of this systematic review was to identify the role of opioid pharmacogenetics in analgesia and adverse events among patients being treated for postpartum pain, along with their breastfeeding infants.

Methods: A comprehensive search of the literature was conducted in seven databases on June 3-4, 2015. Two reviewers independently screened studies for eligibility, extracted data and evaluated study quality using the Newcastle-Ottawa Scale.

Results: Among the 2082 papers retrieved from the search, 17 were included in the review. These 17 papers consisted of various study designs, opioids, polymorphisms and patient outcomes. This systematic review reveals that CYP2D6, OPRM1 A118G, UGT2B7 C802T and ABCB1 G2677AT may contribute to postpartum analgesia or adverse events.

Conclusion: These findings may assist in personalizing care for patients receiving opioids during the postpartum period.

Keywords: adverse events; analgesia; breastfeeding; cesarean section; opioids; pain management; pharmacogenetics; polymorphisms; postpartum.