Researchers shocked to find how common prenatal opioid use is in the U.S., with one-third of women taking the painkillers while pregnant. Here's why it's a problem.
At the risk of stating the obvious, taking a controlled substance while pregnant can be a bad idea. But this even goes for painkillers prescribed by your doctor. A recent study published in Pediatrics is demonstrating just how common opioid use during pregnancy is in the United States, and what that means for newborn outcomes.
Researchers at Vanderbilt University Medical Center found that prescription narcotic painkillers—drugs like hydrocodone (Vicodin), oxycodone (Oxycontin), codeine, and morphine—were being used by an astonishing 28% of subjects in their analysis of more than 100,000 pregnant women. According to lead author Stephen Patrick, M.D., a neonatologist and assistant professor of pediatrics at Vanderbilt, these numbers mirror a larger trend: opioid pain relief use has quadrupled in the past decade in the U.S.
Patrick believes that prescriptions have gone up in part for good reason. There's been an increasing focus on trying to treat pain properly. "But we've found that use exceeds what would be reasonable," he told Fit Pregnancy.
Pregnant women are using these drugs for various reasons, including back pain and headache. But the majority had no indication for using the drugs. Granted, women with opioid dependency have better infant outcomes if they stay on the drug during pregnancy (e.g., lower chance of preterm birth), according to Patrick. Still, no pregnant woman should be taking narcotic painkillers unless absolutely necessary because it can cause something called neonatal abstinence syndrome (NAS), as well as other birth defects.
"A colicky baby times five," is how Patrick describes NAS. "It's a baby who is fussy, inconsolable, and jittery." Seizures can happen, but are less common. Newborns with NAS may have feeding difficulties and they usually stay in the hospital an average of three weeks. Often, they need medication for dealing with the withdrawal.
Taking these outcomes one step further, the researchers found that smoking and using antidepressants just makes the situation worse. Babies are even more likely to be born with NAS and, as a result, they're likely to be of low birth weight and have respiratory conditions.
But women taking these prescriptions shouldn't stop cold turkey because that kind of abrupt cessation is associated with miscarriage. So talk to your doctor before doing anything.
"We need public health solutions going forward," Patrick emphasizes, while noting that 49 states and the District of Columbia have prescription drug monitoring databases to help identify high-risk prescribers. "Physicians should think about whether opioids are necessary and appropriate in any context," he adds.
Thankfully, the CDC recently launched a Treating for Two national initiative, which aims to give patients and healthcare providers more information regarding the use of medications during pregnancy. And this is especially good news considering that according to Patrick there's been an increase in prescribing of all kinds during pregnancy.