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Prenatal Opioid Use Disorder and the Risk of Congenital Anomalies in Offspring: A Population-Based Study

Kaylee Ramage1,2, Jennifer Yee3,4, Sebastian Srugo3

  • 1Department of Community Health Sciences, University of Calgary, Calgary, Canada.

Birth Defects Research
|February 20, 2025
PubMed

Insights

Prenatal opioid use disorder (OUD) diagnosis significantly increases the risk of congenital anomalies (CAs) in newborns. This includes conditions like microcephaly, cleft palate, and heart defects, highlighting a critical public health concern.

Area of Science:

  • Reproductive Health
  • Pediatrics
  • Public Health

Background:

  • Opioid use disorder (OUD) during pregnancy poses risks to both the birthing person and the developing fetus.
  • Congenital anomalies (CAs) are structural or functional abnormalities present at birth, with diverse etiologies.
  • Understanding the impact of prenatal substance exposure on offspring development is crucial for early intervention and prevention strategies.

Purpose of the Study:

  • To investigate the association between a prenatal diagnosis of opioid use disorder (OUD) and the incidence of congenital anomalies (CAs) in offspring.
  • To quantify the risk of specific CAs in infants born to individuals with prenatal OUD.
  • To inform clinical practice and public health initiatives aimed at mitigating risks associated with prenatal OUD.

Main Methods:

  • A population-based study utilizing Canadian birth data from 2006 to 2021.
  • Inclusion of over 4.1 million mother-newborn dyads.
  • Robust Poisson regression analysis to assess the association between prenatal OUD and non-chromosomal CAs, with adjustments for key maternal and infant factors.

Main Results:

  • Infants born to individuals with a prenatal OUD diagnosis exhibited a 2.3-fold increased overall risk of congenital anomalies.
  • Elevated risks were observed for specific CAs, including microcephaly (aRR 5.2), cleft palate (RR 4.8), and pulmonary valve atresia (aRR 2.7).
  • A notable 1.8-fold increased risk of severe congenital heart disease was identified in infants exposed to OUD prenatally.

Conclusions:

  • Prenatal OUD diagnosis is significantly associated with an increased risk of certain congenital anomalies in offspring.
  • The findings underscore the importance of addressing OUD in pregnant individuals to prevent adverse birth outcomes.
  • Further research is warranted to explore the influence of socio-demographic factors on these observed associations.
Abstract

Keywords:
birth defectscongenital anomalycongenital heart diseasecongenital microcephalyopioid use

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