Opioid Pain Use During Pregnancy Increases Risk Of Neonatal Abstinence Syndrome

A team of researchers at Vanderbilt University Medical Center studied neonatal abstinence syndrome (NAS) among infants following birth. The study examined just how commonly pregnant women are being prescribed opioids, otherwise known as narcotic pain relievers that can increase the likelihood of NAS. 

The study authors looked at three years of data from TennCare, Tennessee's Medicaid program, and assessed records for 111,029 pregnant mothers. Findings showed that an estimated 28 percent of the women, or 31,354 were prescribed and filled at least one opioid pain reliever. Sixty-five percent of the mothers had also filled these prescriptions illegally for opioid pain relievers.

"We found that babies exposed to opioids pain relievers were more likely to be born preterm, have complicated births, low birth weight and have complications such as meconium aspiration syndrome (a sign of infant distress at birth) and respiratory distress," said lead author Stephen Patrick, M.D., MPH, assistant professor of Pediatrics and Health Policy in the Division of Neonatology with the Monroe Carell Jr. Children's Hospital at Vanderbilt, in a news release. "Not all babies exposed to opioids have drug withdrawal after birth for reasons that aren't entirely clear. Our study found that several things increased an infant's risk, including the duration of opioid use, the type of prescription opioid, how many cigarettes a woman smoked and if they used a common antidepressant medicine called selective serotonin reuptake inhibitors."

The study compared women with no opioid exposure to pregnant women who took opioid pain relievers and who were likely to be white and have anxiety and/or depression, a musculoskeletal disease and migraines and/or headaches.

Ninety-six percent of the women prescribed opioids were given short-acting medications while another 2 percent received maintenance doses. Less than 1 percent received long-acting opioids.

Statistics show that nationwide, opioid drug use has quadrupled. An estimated 259 million prescriptions have been written for opioid pain relievers in the United States alone. Furthermore, the national health care expenditures for treating babies have been exceedingly expensive, with $50 spent in infant care drug withdrawal for ever $1 spent on short-acting opioid pain relievers.

"All in all we hope the study garners the attention of state and federal policy makers to highlight that the prescription opioid epidemic is having a tangible impact on both mothers and infants," Patrick concluded. 

Tennessee began taking action against overprescribing and doctor shopping for opioids in 2006 when it created a prescription monitoring database, though it was an optional resource for providers and pharmacists. The state strengthened laws in 2013, mandating that providers and pharmacists use the system. Currently 49 states have similar drug monitoring programs. Missouri is the only state without one.

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