Maternal treatment with opioid analgesics and risk for birth defects

Am J Obstet Gynecol. 2011 Apr;204(4):314.e1-11. doi: 10.1016/j.ajog.2010.12.039. Epub 2011 Feb 23.

Abstract

Objective: We examined whether maternal opioid treatment between 1 month before pregnancy and the first trimester was associated with birth defects.

Study design: The National Birth Defects Prevention Study (1997 through 2005) is an ongoing population-based case-control study. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIS) for birth defects categories with at least 200 case infants or at least 4 exposed case infants.

Results: Therapeutic opioid use was reported by 2.6% of 17,449 case mothers and 2.0% of 6701 control mothers. Treatment was statistically significantly associated with conoventricular septal defects (OR, 2.7; 95% CI, 1.1-6.3), atrioventricular septal defects (OR, 2.0; 95% CI, 1.2-3.6), hypoplastic left heart syndrome (OR, 2.4; 95% CI, 1.4-4.1), spina bifida (OR, 2.0; 95% CI, 1.3-3.2), or gastroschisis (OR, 1.8; 95% CI, 1.1-2.9) in infants.

Conclusion: Consistent with some previous investigations, our study shows an association between early pregnancy maternal opioid analgesic treatment and certain birth defects. This information should be considered by women and their physicians who are making treatment decisions during pregnancy.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abnormalities, Drug-Induced*
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Anterior Chamber / abnormalities
  • Case-Control Studies
  • Codeine / administration & dosage
  • Codeine / adverse effects
  • Female
  • Gastroschisis / chemically induced
  • Gastroschisis / epidemiology
  • Glaucoma / chemically induced
  • Glaucoma / epidemiology
  • Heart Defects, Congenital / chemically induced
  • Heart Defects, Congenital / epidemiology
  • Humans
  • Hydrocephalus / chemically induced
  • Hydrocephalus / epidemiology
  • Hydrocodone / administration & dosage
  • Hydrocodone / adverse effects
  • Infant, Newborn
  • Meperidine / administration & dosage
  • Meperidine / adverse effects
  • Multivariate Analysis
  • Oxycodone / administration & dosage
  • Oxycodone / adverse effects
  • Pregnancy
  • Pregnancy Trimester, First
  • Prenatal Exposure Delayed Effects*
  • Pulmonary Valve Stenosis / chemically induced
  • Pulmonary Valve Stenosis / epidemiology
  • Spinal Dysraphism / chemically induced
  • Spinal Dysraphism / epidemiology

Substances

  • Analgesics, Opioid
  • Hydrocodone
  • Meperidine
  • Oxycodone
  • Codeine