Women who use oxycodone, codeine and hydrocodone painkillers early in pregnancy may increase the risk of birth defects, according to a study led by researchers at the Centers for Disease Control and Prevention.
Women who used these prescription pain medications just before they got pregnant, or in the first trimester of pregnancy, were twice as likely to have a baby born with a serious heart defect, the researchers report in the American Journal of Obstetrics and Gynecology.
As far back as the 1970s, studies have shown a link between using opioid painkillers in the first trimester of pregnancy and birth defects. But that didn't change doctor's prescribing practices at all, says Cheryl Broussard, the CDC epidemiologist who led this new study. She looked at data from the National Birth Defects Prevention Study, which has been collecting information on women's use of medications since 1997.
Heart defects saw the greatest increase, including hypoplastic left heart syndrome, in which the left side of the heart doesn't develop properly. It is fatal if not treated with surgery.
And this is the first study to link spina bifida, in which the backbone and spinal canal don't close before birth, with opioid use.
The new study also found slight increases in congenital hydrocephaly, which can cause mental retardation; congenital glaucoma; and gastroschisis, in which a baby is born with intestines outside the body.
The increased risk of birth defects for each woman was very small overall. For instance, the risk of having a baby with hypoplastic left heart syndrome rose from 2.4 per 10,000 live births, to about 5. But almost 3 percent of women say they use prescription opioid pankillers while pregnant; they are commonly prescribed for pain from surgery, infection, chronic illness and injuries. About 1 in every 33 babies in the U.S. is born with a birth defect.
Many women — and their doctors — don't realize that these popular painkillers could pose a risk to their babies, Broussard says.
"It's really important that women talk with their doctors," she says, "and talk about the potential benefits for these medications, as well as the potential risk for heart defects."