Recent studies published in the BMJ suggest that children of pregnant mothers who were prescribed opioids or antibiotics during pregnancy do not have a higher risk of suffering major birth defects.

In recent years, studies have suggested babies who were exposed in utero to drugs prescribed for their mothers, like opioids or antibiotics, could lead to the development of birth defects. Two large new studies shed additional light, and possibly reassurance, for women who are pregnant or planning a pregnancy.

Prescription of painkillers during pregnancy

Painkillers are frequently prescribed during pregnancy. Researchers looking at whether painkillers during pregnancy increase birth defects, note approximately 22 percent of Medicaid patients and 14 percent of commercially insured patients receive at least one opioid prescription during pregnancy.

This study evaluated healthcare data of more than 82,000 women who were prescribed two or more opioid prescriptions during their first trimester. Data was drawn from across the US between the years 2000 and 2014. Researchers sought to understand whether painkillers prescribed during the first part of pregnancy could be teratogens—drugs that can cause abnormal fetal development.

Congenital defects considered included a variety of cardiac defects, neural tube defect, clubfoot and oral cleft, among others.

The study concluded that use of prescription opioids during early pregnancy is not associated with a significant risk of congenital abnormalities. The research does suggest though, that use of opioids during the first trimester resulted in approximately four to five additional children per 10,000 pregnancies born with cleft palate. While this was considered a small increase, study authors encourage physicians to counsel pregnant patients about the risk.

Antibiotics and risk of birth defects

A second study in the BMJ evaluated data from 1.2 million pregnancies between the years of 1997 to 2016. The aim of this Danish study was to determine if macrolide antibiotics (like erythromycin, azithromycin and clarithromycin) increase the risk of birth defects when used during pregnancy.

Study authors note macrolides are some of the more commonly prescribed antibiotics for pregnant women in the US and in Europe. The study found the rate of birth defects in children exposed in utero to macrolide antibiotics was approximately the same as the rate of birth defects in children of women who did not take antibiotics during their pregnancy.

Both studies were observational and assumed drugs prescribed were drugs taken. Overall, the studies deliver some guidance for women and their physicians to be better informed about drugs prescribed during pregnancy.

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