Safely Managing Pain During Pregnancy
Managing pain during pregnancy requires careful consideration, especially when it comes to medication use. A recent study published by the Canadian Medical Association Journal (CMAJ) highlights the risks associated with opioid use during the first trimester of pregnancy, showing a small but significant increase in congenital abnormalities among infants exposed to these medications.
Key Findings from the CMAJ Study
The study, led by Queen’s researchers Dr. Susan Brogly and Alexa Bowie, analyzed health data from Ontario, covering nearly 600,000 mother-infant pairs. The goal was to determine the link between opioid pain medications used in early pregnancy and congenital abnormalities in infants. The findings revealed that two percent of fetuses were exposed to prescribed opioids, which can cross the placenta and potentially cause harm.
Dr. Brogly stated, “This research confirms evidence of a small increased risk of birth defects from opioid analgesic exposure in the first trimester, not attributed to other risk factors for fetal harm in women who may take these medications.”
Also read: Morphine During Pregnancy – Is It Safe?
Opioids and Associated Risks
The study identified that two percent of infants were exposed to opioid pain relief medicines such as codeine, oxycodone, hydromorphone, tramadol, and morphine. Key findings include:
- Tramadol and Morphine: Increased risk of major anomalies.
- Codeine, Hydromorphone, and Oxycodone: Increased risk of minor anomalies.
Specific congenital anomalies observed included gastrointestinal neoplasms, tumors, ankyloglossia (tongue-tie), and genital anomalies.
This large-scale study supports earlier research from Sweden, Norway, and a recent study of pregnant U.S. Medicaid beneficiaries, all suggesting a small but notable risk of congenital anomalies from opioid exposure during pregnancy.
Implications for Pain Management
For pregnant women or those planning to conceive, this research provides critical data to inform pain management decisions. Dr. Brogly emphasizes the importance of this information: “The research benefits women experiencing pain during pregnancy or those planning to conceive by enabling informed choices regarding pain management.”
Pharmacists and physicians play a crucial role in educating expectant mothers about the risks associated with opioid use. However, since opioid exposure might occur before a woman realizes she is pregnant, organizations like the Society of Obstetricians and Gynecologists of Canada and March of Dimes offer updated and reliable information for pregnant women.
Mentorship and Research Contributions
This CMAJ publication marks the first author publication for Alexa Bowie, a graduate of Queen’s Public Health Sciences. Bowie’s involvement in Dr. Brogly’s NIH-funded study during her practicum placement led to her significant contribution to this important research.
“Contributing to this research as part of my practicum was incredibly rewarding,” says Bowie. “Dr. Brogly is an extraordinary mentor whose dedication to supporting future researchers empowered me to grow as an epidemiologist.”
Conclusion
The findings from this study underscore the importance of cautious pain management during pregnancy. While opioids are effective for severe pain, their use during pregnancy, especially in the first trimester, should be carefully considered and discussed with healthcare providers to ensure the safety of both mother and baby.
For more detailed information and guidance, consult healthcare professionals and refer to trusted organizations dedicated to maternal and fetal health.
Also read: Medicines To Avoid During Pregnancy – What You Need To Know
