title: Maternal treatment with opioid analgesics and risk for birth defects.
abstract: OBJECTIVE
  We examined whether maternal opioid treatment between 1 month before pregnancy and the first trimester was associated with birth defects.
  
  
  METHODS
  The National Birth Defects Prevention Study (1997 through 2005) is an ongoing population-based case-control study. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIS) for birth defects categories with at least 200 case infants or at least 4 exposed case infants.
  
  
  RESULTS
  Therapeutic opioid use was reported by 2.6% of 17,449 case mothers and 2.0% of 6701 control mothers. Treatment was statistically significantly associated with conoventricular septal defects (OR, 2.7; 95% CI, 1.1-6.3), atrioventricular septal defects (OR, 2.0; 95% CI, 1.2-3.6), hypoplastic left heart syndrome (OR, 2.4; 95% CI, 1.4-4.1), spina bifida (OR, 2.0; 95% CI, 1.3-3.2), or gastroschisis (OR, 1.8; 95% CI, 1.1-2.9) in infants.
  
  
  CONCLUSIONS
  Consistent with some previous investigations, our study shows an association between early pregnancy maternal opioid analgesic treatment and certain birth defects. This information should be considered by women and their physicians who are making treatment decisions during pregnancy.
authors.affiliation: Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. cbroussard@cdc.gov
authors.forename: Cheryl S
authors.initials: CS
authors.lastname: Broussard
authors.forename: Sonja A
authors.initials: SA
authors.lastname: Rasmussen
authors.forename: Jennita
authors.initials: J
authors.lastname: Reefhuis
authors.forename: Jan M
authors.initials: JM
authors.lastname: Friedman
authors.forename: Michael W
authors.initials: MW
authors.lastname: Jann
authors.forename: Tiffany
authors.initials: T
authors.lastname: Riehle-Colarusso
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Honein
mesh_terms: D000014:Abnormalities, Drug-Induced; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D000867:Anterior Chamber / Q000002:abnormalities; D016022:Case-Control Studies; D003061:Codeine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D020139:Gastroschisis / Q000139:chemically induced / Q000453:epidemiology; D005901:Glaucoma / Q000139:chemically induced / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006849:Hydrocephalus / Q000139:chemically induced / Q000453:epidemiology; D006853:Hydrocodone / Q000008:administration & dosage / Q000009:adverse effects; D007231:Infant, Newborn; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects; D015999:Multivariate Analysis; D010098:Oxycodone / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects; D011666:Pulmonary Valve Stenosis / Q000139:chemically induced / Q000453:epidemiology; D016135:Spinal Dysraphism / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D006853:Hydrocodone; D008614:Meperidine; D010098:Oxycodone; D003061:Codeine