What risks does opioid use during pregnancy pose?

Opioids used during pregnancy might cross the placenta and enter the fetal central nervous system. Although occasional use of opioids during pregnancy doesn't typically pose concerns for the baby, use of opioids close to delivery might cause the baby to experience slow and ineffective breathing (respiratory depression) after birth.

In contrast, many complications have been associated with opioid dependency during pregnancy, including:

• Placental problems, including placental abruption and placental insufficiency
• Premature rupture of membranes
• Preterm labor and premature birth
• Fetal growth restriction
• Preeclampsia
• Miscarriage or fetal death
• Postpartum heavy bleeding
• Inflammation of the fetal membranes (intra-amniotic infection)

However, it's difficult to determine the extent to which these complications are due to opioids or opioid withdrawal. Use of other drugs or your own health, nutritional or psychological conditions might play a role.

If you become opioid dependent during pregnancy, your baby could experience the drug withdrawal syndrome known as neonatal abstinence syndrome. Signs and symptoms, which often begin shortly after birth and might last days to weeks, include:

• Tremors
• Jitteriness
• Diarrhea
• Uncoordinated sucking reflexes that lead to poor feeding
• Irritability
• High-pitched cry
• Poor sleep

Your baby might need to be hospitalized for weeks.