Reproductive
Opioid Use on Pregnancy Outcomes and Congenital Anomalies Xiaoyi Shan* Xiaoyi Shan Arkansas Children’s Research Institute, Arkansas Children’s Hospital
The increased opioid use has been a public health concern for the past two decades. The misuse and abuse of the prescription opioid among women, especially during pregnancy also has been rising significantly. The consequences of the opioid use disorder (OUD) on reproductive health have been reported. The review aims to provide a most up-to-date summary focusing on the pregnancy outcomes and congenital abnormalities. Pubmed search was used for published research on human subject in English between 2005-2025. The keywords combined ‘opioid use disorder’, ‘pregnancy outcome’ ‘spontaneous abortion’, ‘stillbirth’, ‘congenital anomalies’ and ‘birth defect’. Most relevant studies with full text available and were included. Most studies reported chronic opioid use increased the risk of adverse pregnancy outcomes including spontaneous abortion, preterm birth, intrauterine growth restriction, as well as small for gestation age infants. Majority studies reported elevated risk of overall birth defects. The highest risk reported was over two folds, though some studies didn’t find a statistically significant association between OUD and birth defects. Congenital heart defects showed a strong association with opioid exposure during pregnancy, and was the most frequently reported group of anomalies. Other reported congenital anomalies including neural tube defects, gastroschisis, clefts, and limb deficiencies. Due to the complexity of prescription drug abuse such as social stigma, there is lack of data and in-depth analysis on the subject. Some studies had very small sample sizes, and many faced potential methodological challenges. There is a critical need for research to better understand the adverse effects of opioid use on pregnancy outcomes and identify risk factors as well as effective intervention strategies and evidence based recommendations for safe prescription use.