ASRM 2019 — Even limited opioid use may adversely affect reproduction


  • Daniel M. Keller, Ph.D
  • Conference Reports
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Even limited, nondependent opioid use in the pre- and periconception period can adversely affect fecundability and may increase risk for pregnancy loss in the periconception period.

Why this matters

  • Prescription opioid use has increased among reproductive-age women.
  • Although use during pregnancy is known to have adverse outcomes, the risks of limited opioid use in the preconception and early pregnancy periods have been unclear.

Study design

  • Prospective cohort of 1228 women from the Effects of Aspirin in Gestation and Reproduction Study.
  • Women with 1-2 prior pregnancy losses randomly assigned to preconception low-dose aspirin or placebo.
  • Measured urinary opioid concentrations in the preconception period and at 4 and 8 weeks of pregnancy for women who became pregnant.
  • Women self-reported opioid use.
  • Study supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Key results

  • Preconception use: positive urine, 9.0%; self-reported use, 13.6%; urine or self-reported, 19.8%.
  • Positive urine at week 4 or 8: 33/683 pregnancies (4.8%).
  • Use among opioid users: once, 79%; twice, 15%; 3-4 times, 6%.
  • Most common self-reported opioids: hydrocodone, 53%; oxycodone, 29%.
  • Only combining urine detection and self-reported use before conception showed lowered fecundability: OR, 0.76 (95% CI, 0.61-0.94).
  • Only positive urine measurement increased risk ratio (RR) of pregnancy loss: use at week 4 of pregnancy, RR, 2.10 (95% CI, 1.08-4.08); at week 4 or 8, RR, 2.60 (95% CI, 1.32-5.12).
  • No effect of opioid use on live births.

Limitations

  • Potential bias and/or recall error in self-reported use
  • Outcomes not correlated with specific opioids

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit