Elliott TE, et al. - In this retrospective cohort study, the prevalence of opioid use before, during, and after pregnancy was determined and its use based on patient-specific characteristics was described. Secular trend of opioid use from 2006 to 2014 was also determined. Analysis of female individuals age 10 to 50 years with a delivery diagnosis from July 1, 2006 through June 30, 2014 revealed an association of significant opioid use with single marital status, Cesarean section, Medicaid coverage, tobacco use, depression, anxiety, bipolar disorder, substance use disorder, nonopioid analgesic use, and referral to physical therapy, psychotherapy, or pain specialists. A decrease in opioid use from 9% to 6% before, during, and after pregnancy with a rate of change per year of -0.2% was observed from 2006 to 2014. Enhanced assessments and targeted interventions, to reduce unnecessary prescribing and use of opioids among pregnant women and those who might become pregnant, could be achieved via identifying these risk factors. They recommend considering strategies to decrease opioid use during pregnancy in health care systems and health plans to reduce opioid prescribing in this patient population.