ResearchObstetricsMaternal treatment with opioid analgesics and risk for birth defects
Section snippets
Materials and Methods
We analyzed data from the National Birth Defects Prevention Study (NBDPS) for infants born Oct. 1, 1997, through Dec. 31, 2005. NBDPS is an ongoing multisite population-based case-control study of >30 types of major structural birth defects that focuses on exposures immediately before and during pregnancy. Each of the study sites (Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah) ascertains deliveries with birth defects through birth
Results
Of the 17,449 mothers of case infants with various included birth defects, 454 (2.6%) reported opioid analgesic treatment between 1 month before and 3 months after conception. Among 6701 control mothers, 134 (2.0%) reported treatment in this time period. The most commonly reported opioids were codeine (34.5%), hydrocodone (34.5%), oxycodone (14.4%), and meperidine (12.9%), with codeine and hydrocodone exposure being slightly more common among cases, and oxycodone and meperidine exposure
Comment
Using data from a large population-based case-control study, we found associations between maternal therapeutic use of opioid medications in early pregnancy and several types of CHD, consistent with some previous findings for first-trimester use of the opioid codeine.14, 15, 16 Previous reports considered associations with CHD as a single group; we also found a statistically significant association with an aggregate group that includes infants with any 1 of the 15 NBDPS-eligible diagnostic
Acknowledgments
Coding of drug information in NBDPS used the Slone Drug Dictionary, under license from the Slone Epidemiology Center at Boston University, Boston, MA. Centers participating in the NBDPS: University of Arkansas for Medical Sciences, Little Rock, AR (Charlotte Hobbs, MD; U50/CCU613236); California March of Dimes, Oakland, CA (Gary Shaw, DrPH; U50/CCU913241); University of Iowa, Iowa City, IA (Paul Romitti, PhD; U50/CCU713238); Massachusetts Department of Public Health, Boston, MA (Marlene
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This work was supported through cooperative agreements under Program Announcement no. 02081 from the Centers for Disease Control and Prevention to the centers participating in the National Birth Defects Prevention Study, listed as Acknowledgments in this article.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Cite this article as: Broussard CS, Rasmussen SA, Reefhuis J, et al. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol 2011;204:314.e1-11.