RT Journal Article SR Electronic T1 Is periconceptional opioid use safe? JF Canadian Family Physician JO Can Fam Physician FD The College of Family Physicians of Canada SP 431 OP 433 VO 61 IS 5 A1 Felix Chan A1 Gideon Koren YR 2015 UL http://www.cfp.ca/content/61/5/431.abstract AB Question A patient in my practice who takes buprenorphine for chronic pain would like to conceive. Is it safe for her to continue taking her medication? Answer The literature regarding periconceptional opioid use is conflicted as to whether opioids pose an elevated risk of birth defects. Confounding factors such as socioeconomic status, stress, and alcohol consumption might play a role. The first trimester of pregnancy is the critical period of development for many organ systems in the embryo. A chemical or environmental insult is more likely to produce major congenital malformations such as neural tube defects or mental retardation if it occurs within this window. Medical practitioners should judiciously consider a risk-benefit analysis before making their decisions.