Opioids And Miscarriage
Pregnancy loss, or miscarriage, occurs in at least 10-20% of recognized pregnancies. Certain exposures can increase the chance of this adverse outcome. Opioids are a class of medications that include both illegal and legal drugs. Sometimes, opioids are used for short-term pain, such as after surgery. In other instances, people can become dependent on the drug, requiring daily intake to sustain the feeling elicited. When women using opioids experience a pregnancy loss, the question of whether the drug caused the miscarriage can arise.
Pregnancy loss is common
On average, 1 in every 4 pregnancies will end in miscarriage, meaning that pregnancy loss is not an uncommon outcome. That said, the loss can be both physically and emotionally challenging. A miscarriage typically happens during the first few weeks of pregnancy but can technically occur up until 20 weeks. In some cases, a woman may experience no symptoms and will only be alerted to the miscarriage when an ultrasound does not detect a heartbeat. In other instances, cramping and bleeding will indicate something has gone wrong.
The risks of opioids
Since there are so many different types of opioids and indications for use, researchers have a hard time generalizing the results of studies looking at the drug and pregnancy outcomes. The known concern with this class of medication is a risk for withdrawal. When the baby is exposed to opioids during pregnancy, especially if the mom uses daily, dependence is established. Then, once the baby is born, withdrawal symptoms such as irritability, tremors, difficulty feeding, and vomiting can occur. Other studies find a possible risk for preterm birth, lower birth weight, and stillbirth. Such outcomes are more common when illegal opioids, such as heroin, are used often.
What about miscarriage?
Pregnancy loss is notoriously difficult to study since many cases happen early on before a woman even knows about the baby. In other cases, researchers have a hard time pinpointing whether the miscarriage is due to the drug exposure, the underlying condition, or some other factor. Although each drug needs to be evaluated individually, generally speaking, opioids are not expected to increase the chance of miscarriage. This is especially true when the drug is taken short-term and as prescribed under the direction of a healthcare provider.
Get help with OUD
Opioids are incredibly addictive, and many women struggle with opioid use disorder (OUD) after taking a prescribed opioid, eventually moving on to more potent illicit drugs. During pregnancy, management of OUD is essential to prevent relapse. Certain medications can be prescribed as maintenance therapy to help keep women stable and at a low risk of relapse. Treating OUD with recommended medications can increase the chances of a future healthy pregnancy after a miscarriage is experienced.
Getting pregnant on opioids
Although opioid use is not a strongly proven cause of miscarriage, any woman can experience pregnancy loss. In most cases, trying again naturally will be encouraged. However, women who have experienced multiple losses, individuals of advanced maternal age (AMA), and patients with known fertility issues may want to seek out fertility treatment after a loss. Assisted reproductive technology (ART), like in vitro fertilization (IVF), can help women who need to take opioids get pregnant again.
