Birth Defect Risks May Be Impacted by Wide Use of Opioid Painkillers Among Reproductive Women: CDC

A new federal report suggests that a large number of women of childbearing age in the U.S. use prescription opioid painkillers, raising concerns about birth defects associated with use of the medications during pregnancy, as many women may unknowingly expose their unborn child to a risk of severe health problems before they even realize they are pregnant.

The U.S. Centers for Disease Control and Prevention (CDC) issued a press release last week, warning that more than a third of reproductive-aged women on Medicaid and more than one-in-four with private insurance filled an opioid painkiller prescription between 2008-2012. The report was released in the CDC’s Morbidity and Mortality Weekly Report.

Researchers indicate that this may pose a particular risk for women using the drugs who unintentionally become pregnant, exposing their unborn child to a risk of painkiller birth defects.

“Taking opioid medications early in pregnancy can cause birth defects and serious problems for the infant and the mother,” CDC director Tom Frieden said in the press release. “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.”

According to an analysis of data from 2008 to 2012, about 39% of women enrolled in Medicaid from ages 15 to 44 filled a prescription for powerful painkillers like OxyContin, morphine and oxycodone. Among women of the same age on private health care insurance, 28% of women used those drugs during the same time period.

Researchers speculated that medications covered by plans, how the health care services were used, and differences in the prevalence of underlying health conditions could all be factors that attributed to the difference between Medicaid and private insurance prescriptions.

The CDC warned that these drugs could be linked to an increased risk of neural tube defects, congenital heart defects, and abdominal wall defects known as gastrochisis. Newborns could also experience withdrawal symptoms.

The CDC funded a study published in September 2013 which found that women who used opioids may face a 2.2-fold increased risk of having a child with a birth defect.

They found that just under 4% of mothers who gave birth to children with neural tube defects reported having taken opioids, compared with 1.6% of mothers who gave birth to a child without malformations. The researchers concluded that the use of opioids would result in 5.9 children born with neural tube defects out of every 10,000 live births.

Neural tube defects are one of the most common types of birth defects, affecting about one in every 1,000 births in the U.S. They are characterized by a hole in the spinal cord or brain because the neural tube does not close completely. This can result in defects that include spina bifida, and brain malformations that may result in parts of the brain missing or protruding from the skull.

Drug Abuse Concerns

In addition to concerns about birth defects following unintentional pregnancy, widespread use of prescription opioid painkillers among women of childbearing age also highlight the on-going problem with abuse of the narcotics.

In 2012, the CDC named prescription painkiller overdoses a “U.S. epidemic.” The report detailed the increasing numbers of overdose deaths by opioid and narcotic painkillers. The report noted opioid painkillers were responsible for more deaths than cocaine and heroin combined since 2003.

Another more recent CDC report found that women are affected by prescription painkiller abuse more than men. In 2013, the CDC reported that overdose deaths among women are on the rise in the U.S. The CDC found a 400% increase in overdose deaths caused by prescription pain medication among women since 1999.

However, a study released this month suggests the country may be turning a corner on painkiller abuse. A study published in the New England Journal of Medicine on January 15 found that rates of opioid painkiller use declined from 2011 to 2013.

The researchers said that the decline could be attributed to effective intervention and prevention programs launched to battle the drug abuse problem.