Congenital Genitourinary Abnormalities Associated With Prenatal Drug Exposure

Prenatal drug exposure poses a public health dilemma and adversely affects numerous neonatal body systems. Certain drugs during pregnancy may be associated with genitourinary (GU) abnormalities in the neonate, including opiates, cannabinoids, tobacco, alcohol, and psychostimulants. We sought to determine the incidence and characteristics of GU abnormalities in infants who were exposed to maternal drug use during pregnancy.

We identified patients with GU anomalies younger than one year of age who were exposed to maternal prenatal drug use over an 11-year period (January 1, 2014-December 31, 2024). We compared patients with GU abnormalities who were and were not exposed to maternal drug use. GU abnormalities concurrent with other congenital system abnormalities were also assessed.

GU congenital abnormalities were identified in 18,467 (9.1%) of newborns, with 1,076 (5.8%) of these infants prenatally exposed to drugs. Infants prenatally exposed to opioids were 64% more likely to have GU congenital anomalies compared to those without opioid exposure (p < 0.0001). Infants prenatally exposed to cocaine were 59% more likely to have GU congenital anomalies compared to those without cocaine exposure (p = 0.034). Infants prenatally exposed to alcohol were 53% more likely to have GU congenital anomalies compared to those without alcohol (p = 0.043).

Physicians, parents, and other caregivers should be cognizant of the association between GU abnormalities and maternal drug use during pregnancy. Further research is necessary to determine the specific drugs and toxicities associated with GU abnormalities following prenatal drug exposure.