High opioid prescription rates tied to gastroschisis

U.S. counties with high opioid prescription rates had 1.5 times as many babies born with gastroschisis, a serious birth defect of the abdominal wall, compared with counties with low opioid prescription rates, according to research published in MMWR.

“This report is a signal for further research into the entire scope of outcomes after in utero exposure to opioids, including birth defects, [neonatal abstinence syndrome], but also longer term outcomes,” Jennita Reefhuis, PhD, chief of the Birth Defects Branch of the CDC’s National Center on Birth Defects and Developmental Disabilities, told Infectious Diseases in Children.

In their report, Reefhuis and colleagues wrote that “gastroschisis requires surgical repair after birth and is associated with digestive and feeding complications during infancy, which can affect development.”

They also reported that recent data from 14 U.S. states have indicated an increase in the prevalence of gastroschisis between 1995 and 2012.

The researchers reviewed annual data from 20 population-based state birth defects surveillance programs to measure gastroschisis prevalence between 2006 and 2015. The data were divided into two time periods: 2006-2010 and 2011-2015. They compared annual gastroschisis prevalence by annual opioid prescription rate categories.

They reported 3,489 gastroschisis cases among 8,342,741 live births between 2006 and 2019 (4.2 per 10,000 live births) and 4,166 cases among 9,359,005 live births between 2011 and 2015 (4.5 per 10,000 live births).

The prevalence of gastroschisis was highest among infants born to mothers aged younger than 20 years; however, a linear increase in prevalence was observed in older mothers.

The researchers wrote that between 2005 and 2015, the prevalence of gastroschisis was 1.6 times higher in counties with high opioid prescription rates (5.1 per 10,000 live births) and 1.4 times higher with medium prescription rates (4.6 per 10,000 live births) compared with areas with lower prescription rates (3.2 per 10,000 live births).

“This ecologic analysis supports the findings from a large case-controlled study, which suggested that self-reported prescription opioid use in the first trimester was associated with gastroschisis,” the researchers wrote.

Reefhuis urged women who are pregnant or could become pregnant and may have been exposed to opioids to speak with a health care provider.

She said the CDC, the Substance Abuse and Mental Health Services Administration, and the American College of Obstetricians and Gynecologists “consider medication-assisted treatment to be the best practice of care for pregnant women with opioid use disorder. It is important for health care providers to work closely with pregnant women to carefully manage her and her baby’s medical care during pregnancy and after delivery. Coordination of care between OB-GYN, pediatricians and addiction specialists is very important for the well-being of mother and baby.” – by Bruce Thiel

Disclosures : The authors report no relevant financial disclosures.