Opioid Painkillers Tied to Birth Defect Risk

A new government report raises concerns about the use of opioid painkillers during pregnancy.

Expectant mothers who take opioid analgesics such as codeine, oxycodone, or hydrocodone may have a higher risk of delivering babies with birth defects, according to a new study conducted by the Centers for Disease Control and Prevention (CDC).

Reporting in the February 2011 issue of the American Journal of Obstetrics and Gynecology, researchers said that taking the drugs early in pregnancy, or just before pregnancy, increases the risk of congenital heart defects, spina bifida, hydrocephaly, congenital glaucoma, and gastroschisis.

The findings were drawn from the CDC’s National Birth Defects Prevention study, a 10-state project that is the largest ever to focus on the cause of birth defects in the United States. To determine whether opioid use increased risk, researchers compared interview answers of 17,449 mothers whose babies had birth defects and 6701 mothers whose babies were born without defects.

A total of 2.6% of case mothers and 2.0% of control mothers reported using opioid analgesics in the interval beginning 30 days prior to pregnancy and concluding at the end of the first trimester. "Consistent with some previous investigations, our study shows an association between early pregnancy maternal opioid analgesic treatment and certain birth defects," the authors concluded.

The results should help prescribers weigh the risks and benefits of these drugs when considering treatment options for women who are pregnant or at risk for unintended pregnancy. This risk-benefit analysis is particularly important, given that the absolute risk of the drugs causing birth defects is still “modest,” CDC noted.

“It’s important to acknowledge that although there is an increased risk for some types of major birth defects from an exposure to opioid analgesics, that absolute risk for any individual woman is relatively modest,” said lead author, Cheryl S. Broussard, PhD, of the CDC's National Center on Birth Defects and Developmental Disabilities.

She also urged women who are pregnant or planning to become pregnant to discuss their medications with a health care professional. “This includes prescription and over-the-counter medications, as well as dietary or herbal products,” she added.

For other articles in this issue, see:

• Most Americans Oppose Medicare Spending Cuts
• Low Health Literacy to Blame for Medication Misuse