Infants Born to Mothers with Opioid Addiction Face Increased Risk of Death Within First Year: Study

Even pregnant women considered negative for opioid addiction up to six months before delivery, still gave birth to infants that faced an increased risk of death

New research highlights another serious consequence from the on-going opioid abuse epidemic in the United States, suggesting that infants born to women with an opioid addiction are more likely to die within their first year of life.

In findings published recently in the Journal of the American Medical Association (JAMA), researchers found that pregnant women who abuse opioids are more than twice as likely to deliver infants who die before they reach one year old, even if the expecting mother reduces or eliminates her opioid abuse in early pregnancy.

It is well established that opioids like codeine, fentanyl, and oxycodone increase risk of infant death when used during pregnancy. Health experts associate prenatal opioid exposure with a dangerous and life threatening conduction, known as neonatal opioid withdrawal syndrome (NOWS), which may cause a newborn to experience drug withdrawal symptoms.

Infants with NOWS, more commonly known as neonatal abstinence syndrome, often suffer from convulsions, breathing issues, and feeding problems. However, these new findings suggest the powerful pain medications may have long-lasting effects on women who later become pregnant, also increasing the risk of death from other causes.

Maternal Opioid Addiction Linked to Higher Infant Death Rates

In this study, Vanderbilt University Medical Center researchers sought to determine  mortality risk among infants diagnosed with neonatal abstinence syndrome (NOWS), and/or born to mothers diagnosed with opioid use disorder (OUD).

Researchers examined data on 390,075 infants born from 2007 through 2018 to expectant mothers enrolled in Tennessee Medicaid. Within that data set, they measured infant opioid exposure from 183 days before delivery to 28 days after delivery and followed up with infants from 29 days post partum through day 365, or death. They identified infant deaths using corresponding death certificates through 2019.

Infant opioid exposure included birth to a mother with an opioid use disorder (OUD) or a neonatal abstinence syndrome (NOWS) diagnosis after birth. Researchers defined a pregnant woman as positive for opioid use disorder if she had an official opioid addiction diagnosis or a maintenance medication prescription within six months of delivery. Maintenance medications are used to treat opioid use disorders and include drugs like methadone and buprenorphine.

Researchers then enrolled women into four groups: OUD positive/NOWS positive, OUD positive/NOWS negative, OUD negative/NOWS positive, and OUD negative/NOWS negative, unexposed.

Their findings suggest elevated infant mortality rates for all groups showing infant opioid exposure, compared to the unexposed group. While the unexposed group displayed an infant death rate of 3.47 per 1,000, mortality rates increased to 8.41 per 1,000 for infants in the OUD positive/NOWS positive group. Death rates rose even higher for infants in the OUD positive/NOWS negative group, at 8.95 per 1,000.

Researchers observed the highest infant death rate in the OUD negative/NOWS positive group. That group’s infant mortality incidence was 9.25 per 1,000, suggesting that women who abuse opioids early in their pregnancy and then stop still deliver infants with an elevated death rate.

Compared to unexposed infant deaths, children in the three other groups were more likely to die from causes such as accidental suffocation or bed strangulation. Infant deaths linked to opioid exposure were attributed less frequently to congenital malformations or other natural causes relative to the unexposed group.

The researchers concluded that rates of maternal opioid addiction and neonatal abstinence syndrome have increased in recent years, potentially putting more infants at risk of preventable death. They cited previous studies showing that pregnant and post-partum women with addiction issues struggle with accessing treatment. This lack of support can result in decreased quality of care for their infants once they leave the hospital, they warned.

“Our findings suggest that comprehensive support for mothers with OUD and their babies should extend beyond pregnancy and delivery, into long-term pediatric care that offers a wide range of support services,” they wrote.

Neonatal Abstinence Syndrome Lawsuits

Prior studies have indicated opioid use during pregnancy may also lead to debilitating birth defects, including exposed intestines. In recent years, neonatal abstinence syndrome problems have increased due to the worsening opioid epidemic, leading to serious long-term health concerns for children.

Infants born with opioid withdrawal symptoms have skyrocketed in recent years, with estimates indicating opioid addiction among pregnant women has increased more than 300%.

While thousands of opioid lawsuits are being pursued against drug makers for fueling the abuse and addiction problems that have plagued communities throughout the United States, there are also a number of neonatal abstinence syndrome lawsuits being filed on behalf of infants who experienced side effects from exposure to the medications before birth.