There's been an increase in prescribed opioid use among women during pregnancy, and it's probably contributed to the rise in neonatal abstinence syndrome, according to a new report.
In the U.S., approximately 14 to 22 percent of women reportedly receive opioid prescriptions during pregnancy. What's more, the incidence of neonatal abstinence syndrome—a serious medical condition that results from a newborn who was exposed to addictive illegal or prescription drugs while in the mother's womb—increased from 1.20 to 3.39 per 1,000 live births between the years 2000 and 2009.
"High prescribing rates of opioids to women during pregnancy have probably contributed to recent increases in neonatal abstinence syndrome," confirmed Nora Volkow, director of the National Institute on Drug Abuse. "The steep increase in the number of opioid prescriptions dispensed in the United States has been associated with a parallel rise in their misuse, fatal overdoses, and heroin use."
While the effects of opioid exposure on the fetal brain are largely unknown, studies in rodents have linked usage during pregnancy to birth defects in the central nervous system, and human epidemiological studies have found an association between opioid use and neural tube defects and other birth defects.
Additional studies have also indicated that opioid exposure could disrupt attachment between mother and baby, and cognitive impairments have been reported in children and young people born to women who misused opioids during pregnancy.
As such, Volkow recommends that opioids should only be prescribed to pregnant women with severe pain that cannot be controlled with less harmful treatments, and ideally they should be limited to short-term use in order to reduce the risk of harm.
She did add, however, that if long-term use is unavoidable—for women in need of treatment for heroin addiction, for example—then careful assessment and monitoring should be carried out to reduce the risk of overdose, misuse, and neonatal abstinence syndrome.