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Pregnancy Loss: An Unexpected Casualty of Opioids

Learning more about the effects of taking Opioids, both while trying to conceive and within the first few weeks of pregnancy.

September 16, 2020
Brooke Barash

Opioids are not something typically associated with pregnancy. When we think of them, it’s usually in the context of addiction. But the fact is, not everyone who takes opioids misuses them. Much of the time, people begin taking them to soothe major physical pain and stop when things become manageable. We also don’t connect prescription pain medication with pregnancy loss and fertility issues. This is mainly because there hasn’t been much research linking the two. That is, until now.

There are many factors which may contribute to fertility issues and miscarriage:

  • Endometriosis
  • Maternal age
  • Hormonal Imbalance
  • Polycystic Ovarian Syndrome
  • Uterine Abnormalities
  • Compromising medications (i.e. Accutane)

These are just a few of a multitude of risk factors. New research adds one more to the list.

Newborn baby in hospital
When thinking about future little ones, it’s important to consider any factor that might affect their  development. Image courtesy of the Raising Children Network.

Opioid Use And Established Pregnancy

It’s no secret that opioids present certain risks for everyone. Even when taken as prescribed there’s a possibility for tolerance and addiction, along with other common side effects. With that, it’s easy to imagine that these risks are only augmented when adding pregnancy into the mix. 

Well-established research covers what can happen when those who are expecting are exposed to prescription pain medications, both during and after pregnancy. This means that adverse effects may either affect the health of mothers, their babies, and at times both.

For expectant mothers, one of the most grave possibilities is maternal death, along with potential dependency.

For infants, there are a number of risk factors both in and out of the womb. Some of these include premature birth, poor fetal growth, as well as birth defects. 

One particularly difficult-to-observe infantile effect of opioid usage during pregnancy is Neonatal Abstinence Syndrome (otherwise known as Neonatal Opioid Withdrawal Syndrome). This typically occurs when babies are exposed to substances in the womb. When they are born, they might begin exhibiting a series of symptoms typically associated with substance withdrawal, like tremors, seizures, vomiting, etc. Symptoms of this nature will usually start to show about three days after birth. 

Woman frustrated when looking at pregnancy test
Having trouble conceiving can be a difficult process to say the least. If you have been prescribed pain medication, it may be a good idea to consult your doctor. Image courtesy of TheHealthSite.com.

New Information On Opioids and Miscarriage 

 A new study released in August 2020 by The National Health Institute suggests that opioid use may also be linked to pregnancy loss and difficulties while trying to conceive. While the risks of taking prescription pain medication during pregnancy and after birth are well documented, there hasn’t been research done on sporadic, non-habitual use.

This is exciting because it steers the conversation surrounding opioids away from drug dependency and into a realm where it can be used to find answers for women who are struggling with fertility. 

In their research, scientists took a group of child-bearing aged women who had gone through miscarriage during past pregnancies. In taking urine samples from the group they followed, they found that a number of women had taken opioids while trying to conceive while others had taken them during early pregnancy. 

From there, researchers looked for traces of drugs used to treat opioid dependence. Of all 1,228 samples they tested, there were none to be found. 

For those who were unable to get pregnant, researchers continued to follow them for six months, tracking their monthly cycles. Women who did conceive were tracked throughout their pregnancies.

Here’s what they found:

Women who took opioids before while trying to get pregnant had a 29% lower chance of conceiving during regular monthly cycles than had they not taken the medication.

For women who had been successful in getting pregnant, the focus was on pregnancy loss. In this portion of the study, researchers focused on opioid use during the formative weeks of early pregnancy. Those who took prescription pain medication close to the time of conception were twice as likely to have a miscarriage. After that, the likelihood of pregnancy loss only increased. Women who took opioids during the first four weeks of pregnancy were found to be 2.5 more susceptible to losing their pregnancy. 

Woman awaiting results at fertility appointment
When trying to conceive, it’s important to speak with your health care professional about any medications you may be taking. Image courtesy of Gustavo Fring via Pexels. 

The Takeaway

The authors of the study noted that more research is required to understand the extent of how opioid use affects fertility and early pregnancy.

It’s also important to note that these methods are not foolproof since many women are not aware that they are pregnant until much later into their term. 

“Our findings indicate that women who are pregnant or planning a pregnancy should, along with their physicians, consider the potential effects opioids may have on their ability to conceive or sustain a pregnancy”

Taking these findings into account, people who are intentionally trying to have children might consider taking a more benign route when it comes to pain management. Some options may include more accessible medications, like aspirin. Opting for more low-level pain relievers might actually do more for expectant parents as they have shown to help prevent pregnancy loss.

But for now, women who want to become pregnant might consider discussing the pros and cons of taking prescription pain meds with their doctors. This is important because doctors often prescribe opioids to pregnant women in order to manage their pain. This is especially relevant  for women undergoing reproductive procedures, like In Vitro Fertilization (IVF). 

With newfound information, those who want to have children have the opportunity to make informed decisions regarding pain alleviation. While there are a myriad of reasons why one might struggle to keep a pregnancy afloat, this new research provides insight for parents and doctors alike. The findings on opioids are in their infancy, but already provide a wealth of knowledge. Who knows what they’ll find next!

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