Opiod Use By Women of Child Bearing Age

CDC: low awareness among women of birth defect risk from opioids

Pregnancy can throw up a million and one questions and niggling aspects: morning sickness, constipation and tiredness. One of the more irksome sides is the seemingly endless changing list of things to avoid. The CDC has released a report suggesting that women of childbearing age that may be in the dark about the implications of taking commonly prescribed opioids during pregnancy, and the subsequent increased risk of some birth defects.
pregnant woman with pills
Analysis showed that on average 28% of women with private health care and 39% of Medicaid-enrolled women filled an opioid prescription from an outpatient pharmacy each year.
Opioids are medications that are prescribed by health care providers to relieve moderate to severe pain, and are also found in some cough medicines. They reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus.

According to the Morbidity and Mortality Weekly Report (MMWR), published by the US Centers for Disease Control and Prevention (CDC), more than one-fourth (28%) of privately-insured and one-third (39%) of Medicaid-enrolled women of childbearing age filled prescriptions for opioid-based painkillers between 2008 and 2012.

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

Dr. Coleen A. Boyle, director of CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD), states:

“This highlights the importance of promoting safer alternative treatments, when available for women of reproductive age. We must do what we can to protect babies from exposure to opioids.”

The CDC researchers analyzed 2008-2012 data from two large health insurance claims datasets: one of women aged 15-44 with private insurance and another of women in the same age group enrolled in Medicaid.

The most commonly prescribed opioids between both groups of women were hydrocodone, codeine and oxycodone.

The research ‘underscores the importance of responsible prescribing’
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)
Neonatal abstinence syndrome (NAS) from exposure to medications such as opioids in pregnancy. NAS can be experienced from symptoms of withdrawal from medications or drugs taken by a mother during pregnancy.
march of dimes infographic
If you are pregnant, speak to your doctor right away about all your medications.
Image source: March of Dimes
“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,” comments Dr. Boyle. “This new information underscores the importance of responsible prescribing, especially of opioids, for women of childbearing age.”

Dr. José F. Cordero, a pediatrician, birth defects expert formerly at CDC, and a member of the March of Dimes Board of Trustees adds:

“If you are using an opioid painkiller, you should also be practicing effective birth control. If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking right away. You may be able to switch to a safer alternative.”

In the US, a baby is born with a birth defect every 4.5 minutes, and a birth defect causes one out of every five deaths in the first year of life. In addition to the human toll, birth defects incur hospital-related economic costs that exceed $2.6 billion annually.

“The CDC’s ‘Treating for Two: Safer Medication Use in Pregnancy’ initiative offers information to women and their healthcare providers about medication use during pregnancy,” says Dr. Boyle.

“This initiative aims to prevent birth defects and improve the health of mothers by working to identify the best alternatives for treatment of common conditions during pregnancy and during the childbearing years,” she concludes.

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