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Cleft Lip and/or Palate in Infants Prenatally Exposed to Opioids

Kerry Proctor-Williams1, Brenda Louw1

  • 1Department Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|May 7, 2021
PubMed

Insights

Prenatal opioid exposure (OE) significantly increases the risk of cleft lip and/or palate (CL/P) in newborns. Infants with OE or neonatal opioid withdrawal syndrome (NOWS) had higher CL/P prevalence than unexposed infants.

Area of Science:

  • Public Health
  • Pediatrics
  • Teratology

Background:

  • Prenatal opioid exposure is a growing concern with potential adverse effects on infant development.
  • Cleft lip and/or palate (CL/P) are common congenital anomalies with multifactorial etiologies.
  • Understanding environmental risk factors for CL/P is crucial for prevention and intervention strategies.

Purpose of the Study:

  • To determine the prevalence and odds ratios for CL/P in infants with prenatal opioid exposure (OE), with or without neonatal opioid withdrawal syndrome (NOWS).
  • To compare CL/P rates in exposed infants to a control group of infants with no opioid exposure (NOE).

Main Methods:

  • Retrospective cohort study utilizing newborn medical health records from 2011 to 2016 in South Central Appalachia.
  • Three infant cohorts were analyzed: OE (N=168), NOWS (N=294), and NOE (N=16,090).
  • Prevalence and odds ratios for CL/P were calculated and compared across the groups.

Main Results:

  • Infants with OE and NOWS exhibited significantly higher prevalence and odds ratios for CL/P compared to the NOE group.
  • Prevalence rates per 1000 live births were 35.71 for OE, 6.80 for NOWS, and 1.37 for NOE.
  • OE infants showed increased odds for CL/P, isolated cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP); NOWS infants showed increased odds for CL/P and CP.

Conclusions:

  • Prenatal opioid exposure (OE) is a significant environmental risk factor contributing to CL/P.
  • These findings underscore the importance of addressing maternal opioid use during pregnancy.
  • Further research into the specific mechanisms linking OE to CL/P is warranted.
Abstract

Keywords:
drug useepidemiologyetiologyfetal developmenthard palatepalatal developmentprenatal developmentsoft palate

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