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The U.S. Centers For Disease Control and Prevention reports that many women of child-bearing age (notably, women on Medicaid) are taking opioid pain medications and that these drugs taken during pregnancy can increase the risk of birth defects.
According to the agency's latest Morbidity and Mortality Weekly Report:
During 2008–2012, more than one fourth of privately insured and more than one third of Medicaid enrolled reproductive-aged women (15–44 years) filled a prescription for an opioid from an outpatient pharmacy each year. Prescription rates were consistently higher among Medicaid-enrolled compared with privately insured women.
The most frequently prescribed opioids, says the CDC, were hydrocodone, codeine and oxycodone.
The report details why early exposure is particularly risky:
"The development of birth defects often results from exposures during the first few weeks of pregnancy, which is a critical period for organ formation. Given that many pregnancies are not recognized until well after the first few weeks and half of all U.S. pregnancies are unplanned, all women who might become pregnant are at risk."
Here's more from the CDC news release:
Opioids are typically prescribed by health care providers to treat moderate to severe pain. They are also found in some prescription cough medications...
“Taking opioid medications early in pregnancy can cause birth defects and serious problems for the infant and the mother,” said CDC Director Tom Frieden, M.D., M.P.H.
“Many women of reproductive age are taking these medicines and may not know they are pregnant and therefore may be unknowingly exposing their unborn child. That’s why it’s critical for health care professionals to take a thorough health assessment before prescribing these medicines to women of reproductive age.”
CDC researchers analyzed 2008-2012 data from two large health insurance claims datasets: one of women aged 15-44 years with private insurance and another of women in the same age group enrolled in Medicaid. They found that, on average, 39 percent of Medicaid-enrolled women filled an opioid prescription from an outpatient pharmacy each year compared to 28 percent of women with private health insurance.
The higher opioid prescribing rates among Medicaid enrollees might be due to differences in the prescription medications covered under their health insurance plan, differences in use of health care services, or differences in the prevalence of underlying health conditions among Medicaid enrollees compared with persons covered by private health insurance.
Geographic region data available in the private insurance claims indicated that opioid prescription rates were highest among reproductive-aged women in the South and lowest in the Northeast. Race/ethnicity information was available for the Medicaid data and indicated opioid prescriptions were nearly one and a half times higher among non-Hispanic white women of reproductive age compared to non-Hispanic black or Hispanic women.
Previous studies of opioid use in pregnancy suggest these medications might increase the risk of neural tube defects (major defects of the baby’s brain and spine), congenital heart defects and gastroschisis (a defect of the baby’s abdominal wall). There is also a risk of neonatal abstinence syndrome (NAS) from exposure to medications such as opioids in pregnancy. NAS is when a newborn experiences symptoms of withdrawal from medications or drugs taken by a mother during pregnancy.
“Women, who are pregnant, or planning to become pregnant, should discuss with their health care professional the risks and benefits for any medication they are taking or considering.” said Coleen Boyle, Ph.D., MS.Hyg., Director of CDC’s National Center on Birth Defects and Developmental Disabilities. “This new information underscores the importance of responsible prescribing, especially of opioids, for women of child bearing age.”
Here's more from the CDC on the possible risks of taking medications during pregnancy.
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