Pain Killers in Pregnancy: Prescription Opioid Epidemic and Infant Outcomes

Opioids During Pregnancy Put Babies at Risk

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Infants exposed to opioid pain relievers were more likely to experience a variety of health problems, including low birth weight. Newborns whose pregnant mothers were prescribed opioid drugs may undergo neonatal abstinence syndrome — withdrawal symptoms, essentially. Infants suffering withdrawal may experience breathing problems, convulsions, vomiting, diarrhea, high-pitched crying, poor appetite, jitteriness, tremors, sweating, fever, mottled skin, and excessive sucking or rooting. Image Will Murphy.

2015 Study Abstract

Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is poorly described. Our objectives were to identify neonatal complications associated with antenatal opioid pain reliever exposure and to establish predictors of neonatal abstinence syndrome (NAS).

We used prescription and administrative data linked to vital statistics for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011. A random sample of NAS cases was validated by medical record review. The association of antenatal exposures with NAS was evaluated by using multivariable logistic regression, controlling for maternal and infant characteristics.

Of 112 029 pregnant women, 31 354 (28%) filled ≥1 opioid prescription. Women prescribed opioid pain relievers were more likely than those not prescribed opioids (P < .001) to have depression (5.3% vs 2.7%), anxiety disorder (4.3% vs 1.6%) and to smoke tobacco (41.8% vs 25.8%). Infants with NAS and opioid-exposed infants were more likely than unexposed infants to be born at a low birth weight (21.2% vs 11.8% vs 9.9%; P < .001). In a multivariable model, higher cumulative opioid exposure for short-acting preparations (P < .001), opioid type (P < .001), number of daily cigarettes smoked (P < .001), and selective serotonin reuptake inhibitor use (odds ratio: 2.08 [95% confidence interval: 1.67–2.60]) were associated with greater risk of developing NAS.

Prescription opioid use in pregnancy is common and strongly associated with neonatal complications. Antenatal cumulative prescription opioid exposure, opioid type, tobacco use, and selective serotonin reuptake inhibitor use increase the risk of NAS.

Sources and More Information
  • Pill-pushing doctors endanger babies by prescribing opioid painkillers to pregnant women, naturalnews, August 15, 2015.
  • Prescription Opioid Epidemic and Infant Outcomes, American Academy of Pediatrics, (doi: 10.1542/peds.2014-3299), February 10, 2015.
  • Drug addict babies: Common pregnancy pain drugs leave newborns suffering horrific withdrawal symptoms, mirror, 14 April 2015.
  • Opioids During Pregnancy Put Babies at Risk, medpagetoday, 04.13.2015.
  • Pregnant Women Prescribed Opioids Have Babies More Likely To Suffer Complications, Withdrawal Symptoms, medicaldaily, Apr 14, 2015.

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