Prenatal Exposure to Opioids Linked to Higher Risk of Infections, Skin Problems: Study

The findings of a new study suggest exposure to opioid pain medications during pregnancy may increase the risk of dangerous infections and other health conditions for children, both before and after they are born.

Researchers from the University of Western Australia and Johns Hopkins University School of Medicine published a report this month in the medical journal JAMA Network Open, indicating that babies exposed to opioids before birth were more likely to be born with immune-related health issues, including infections, asthma, eczema, and allergic reactions, or develop them before they reach the age of five.

Use of opioids, such as codeine, fentanyl, and oxycodone during pregnancy has been shown to cause serious and sometimes life-threatening health conditions or birth defects in newborns. Prior research has shown babies exposed to the powerful pain killers before birth are more likely to die before they reach one year old.

Exposure to, as well as withdrawal from, opioids has been shown to suppress the immune system in adults, which can result in increased instances of infections and other immune-related health conditions. However, data is limited in how prenatal opioid exposure impacts the immune system of unborn babies, and if exposure leads to immune system diseases in childhood.

The researchers used data on 401,462 babies born in Western Australia between January 1, 2003, and December 31, 2018, of which 1,656 were exposed to two or more opioid medications before they were born. Among those exposed to opioids prior to birth, 70.8% were exposed during the first pregnancy trimester, 73.7% were exposed during the second trimester, and 76.4% in the third trimester. Researchers analyzed participants’ health when they were born and followed up with them yearly for nearly five years to determine how prenatal opioid exposure affected them.

According to the findings, prenatal opioid exposure was associated with increased risks of respiratory, neurologic, eye, digestive tract, skin, soft tissue, and viral infections, as well as eczema and dermatitis, compared to those who were not exposed. Neonatal abstinence syndrome (NAS), a serious condition where infants born to mothers with a drug addiction experience withdrawal symptoms, was also seen among the exposed infants, and was associated with the development of infections and skin conditions.

The data also revealed those exposed to opioids before birth faced an increased risk of developing asthma severe enough to require hospitalization before they reach five years old, compared to those who were not exposed. Those exposed to opioids prescribed for opioid use disorder had higher instances of developing childhood eczema or dermatitis, while those exposed to opioids prescribed for pain had higher instances of yeast, urinary tract, conjunctivitis, and sepsis infections.

Prenatal Opioid Exposure Health Risks

Prior research has shown babies exposed to opioids before birth are at risk of being born with debilitating birth defects and other serious health conditions.

A recent study linked a new syndrome to prenatal fentanyl exposure, which causes exposed babies to be born with cleft palates, clubbed feet, and other birth defects. The deformities seen among the exposed infants were similar to those diagnosed with Smith-Lemli-Opitz syndrome, a developmental disorder that causes learning disabilities and physical birth defects.

Another serious health condition linked to opioid exposure before birth is neonatal abstinence syndrome, when infants are born with withdrawal symptoms, primarily from opioids. The side effects experienced among infants from exposure to the medications during pregnancy has resulted in a number of neonatal abstinence syndrome lawsuits against the drug manufacturers and distributors.