A large new study suggests that prescribed opioid pain medications taken during pregnancy may not significantly increase a child’s risk of developing autism or attention-deficit/hyperactivity disorder (ADHD).
The research, led by Emma N. Cleary, PhD, of Indiana University Bloomington, was published September 16 in PLOS Medicine. It challenges earlier studies that had suggested a possible link between prenatal opioid exposure and higher rates of neurodevelopmental disorders.
What the Study Found
Opioids are sometimes prescribed during pregnancy to manage moderate to severe pain, but their potential impact on a child’s brain development has been unclear.
To investigate, researchers analyzed health records from more than:
1.2 million children born in Sweden between 2007 and 2018 to study autism rates.
900,000 children born between 2007 and 2015 to study ADHD rates.
They compared outcomes among children whose mothers had filled prescriptions for opioid pain medications during pregnancy with those who had not.
- By age 10, autism was diagnosed in:
- 2.0% of children unexposed to opioids,
- 2.9% of children with low-dose exposure, and
- 3.6% of children with high-dose exposure.
Rates of ADHD showed a similar pattern. However, when researchers accounted for genetic and environmental factors that could confound results, the apparent increase in risk largely disappeared.
Important Caveats
The study did not include pregnancies involving extremely high or long-term opioid use, since such prescriptions are rare in Sweden. Researchers caution that risks in those circumstances remain unclear.
Still, the findings offer reassurance that, at typical prescription levels, opioid pain medications during pregnancy are unlikely to substantially raise the risk of autism or ADHD.
What This Means for Patients
Decisions about managing pain during pregnancy are often complex. Dr. Cleary emphasized that this study may help expectant parents and their physicians make more informed choices.
“Pregnant individuals and their physicians must weigh the importance of treating painful conditions with concerns about potential impacts on child development,” she said. “While we cannot rule out small risks with higher exposures, our results suggest that prescribed opioid use is not a direct cause of autism or ADHD.”
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