Opioid use in pregnant women is linked to higher risk of birth defects

The risk of certain birth defects is higher in women given opioid analgesics such as hydrocodone during pregnancy, a new study reported.

Researchers with the Centers for Disease Control and Prevention (CDC) found that women who took codeine, hydrocodone, and other opioids just before pregnancy or in their first trimester were twice as likely to have babies with a serious heart defect. The study, published in a recent issue of the American Journal of Obstetrics and Gynecology, was based on data from the National Birth Defects Prevention Study.

Treatment with opioid analgesics was linked to spina bifida, hydrocephaly (a buildup of fluid in the brain), glaucoma, gastroschisis (a defect of the abdominal wall), and congenital heart defects.  Codeine and hydrocodone were used most frequently, representing 69% of the opioid analgesics used. The women were taking the medications for surgical procedures, chronic diseases, infections, and injuries.

Congenital heart defects are among the most common birth defects, affecting nearly 1% of U.S. births, and are the main contributor to infant death attributable to birth defects, according to the CDC’s National Center on Birth Defects and Developmental Disabilities.

Links between the use of opioid analgesics and the occurrence of hydrocephaly, glaucoma, or gastroschisis have not been observed in previous studies and deserve further investigation.

"It's really important that women talk with their doctors and talk about the potential benefits for these medications, as well as the potential risk for heart defects,” said Cheryl Broussard, the CDC epidemiologist who led the study.