Opioids in pregnancy ‘not linked’ to high risk of child disorders

Their large study found use of short-term, low-dose opioids after the first trimester seemed relatively safe in terms of neuropsychiatric disorders, like attention deficit hyperactivity disorder (ADHD).

“These results support cautious opioid prescribing for relief of pain during pregnancy”

Study authors

A slightly increased risk of neuropsychiatric disorders was identified, but the researchers said this should not be considered clinically meaningful.

This was because it was limited to mothers exposed to more than one opioid prescription, high doses, and over longer time periods during pregnancy.

Previous studies have shown mixed findings on the association between opioid use in pregnancy and various health outcomes in offspring due to small sample sizes and short follow-up periods.

As a result, an international team of researchers investigated the potential association between opioid exposure during pregnancy and risk of neuropsychiatric disorders in offspring.

Their findings are based on data from the National Health Insurance Service of South Korea for 3,128,571 infants born between 2010 and 2017, and 2,299,664 mothers.

Mothers were grouped according to dose, duration, and frequency of opioid prescriptions during pregnancy and infants were followed up for an average of six years.

Factors including mother’s age at delivery, household income and pre-existing health conditions, and infant sex, birth weight and breastfeeding history were taken into account.

A sibling comparison analysis was also carried out to account for genetics, lifestyle, and environmental influences.

Overall, 216,012 (7%) of the infants in the study were exposed to opioids during pregnancy, according to the findings published in the British Medical Journal.

A small increased risk of neuropsychiatric disorders was found among those exposed to prescription opioids during pregnancy compared to children not exposed, but this was clinically insignificant.

In addition, no significant association was noted in the sibling comparison group, said the researchers, which included UK academics from Anglia Ruskin University.

However, exposure to prescription opioids during the first trimester of pregnancy, at higher doses, and for 60 days or more were associated with a slightly increased risk of mood disorders, ADHD, and intellectual disability.

The study authors said: “These results support cautious opioid prescribing for relief of pain during pregnancy, highlighting the importance of further research for more definitive guidelines.”