Related Experiment Video

Updated: May 10, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

85.7K

Neural tube defect risk in relation to opioid analgesic exposure during early pregnancy

Denise M Boudreau1, Gaia Pocobelli1, Jennifer F Bobb1

  • 1Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, United States.

American Journal of Epidemiology
|April 23, 2025
PubMed

Insights

This study found no definitive link between early pregnancy opioid use and neural tube defects (NTDs). More research is needed to confirm or refute this potential risk for birth defects.

Area of Science:

  • Obstetrics and Gynecology
  • Teratology
  • Pharmacoepidemiology

Background:

  • Prescription opioid analgesic use during pregnancy is a growing concern.
  • The potential association between early pregnancy opioid exposure and neural tube defects (NTDs) requires further investigation.

Purpose of the Study:

  • To evaluate the risk of NTDs in infants born to mothers who used prescription opioid analgesics during early pregnancy.
  • To compare NTD risks between opioid-exposed and unexposed pregnancies.

Main Methods:

  • A cohort study was conducted using data from nine U.S. health plans (2001-2014).
  • Liveborn singletons were analyzed for primary NTDs (anencephaly, select spina bifida) and any NTD.
  • Maternal new opioid use during 18-56 days post-LMP was compared to no maternal use.

Main Results:

  • Adjusted odds ratios (ORs) for primary NTD and any NTD were 3.0 (95% CI: 0.7, 12.7) and 2.3 (95% CI: 0.8, 6.7), respectively.
  • Sensitivity analyses yielded similar ORs (2.4 and 1.6).
  • Increased ORs in the main analysis were potentially influenced by residual confounding.

Conclusions:

  • The study results do not conclusively support or refute the hypothesis linking early pregnancy opioid exposure to increased NTD risk.
  • Residual confounding may explain the observed associations.
  • Larger, well-powered studies with robust confounder adjustment are needed but present significant challenges.

Keywords:
birth certificatescohort studyelectronic health recordsmedication exposure in pregnancy risk evaluation programneural tube defectsopioidspregnancy

More Related Videos

Preclinical Model of Prenatal Delta-9-Tetrahydrocannabinol Exposure to Assess Its Impact on Neurodevelopmental Outcomes05:25

Preclinical Model of Prenatal Delta-9-Tetrahydrocannabinol Exposure to Assess Its Impact on Neurodevelopmental Outcomes

Published on: February 28, 2025

129
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats07:36

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

11.2K

Related Concept Videos

Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
2.3K
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
397
Neurulation01:30

Neurulation

Neurulation is the embryological process which forms the precursors of the central nervous system and occurs after gastrulation has established the three primary cell layers of the embryo: ectoderm, mesoderm, and endoderm. In humans, the majority of this system is formed via primary neurulation, in which the central portion of the ectoderm—originally appearing as a flat sheet of cells—folds upwards and inwards, sealing off to form a hollow neural tube. As development proceeds, the...
41.2K
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
171
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
396
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
137