A recent study published in the American Journal of Obstetrics and Gynecology found that expecting mothers who take codeine and other similar opioid pain medications during pregnancy have an increased risk of giving birth to babies with serious congenital abnormalities. Birth defects linked to codeine by the study include heart problems, spina bifida, and gastroschisis (a herniation of the intestines through the abdominal wall). The risk for these defects is greatest when codeine is taken during the first trimester of pregnancy, a time when many women may still be unaware they are pregnant.
What is Codeine?
Codeine is a widely-used narcotic pain reliever and cough suppressant that is structurally similar to morphine and Vicodin (hydrocodone). Like morphine, codeine binds to opioid receptors in the brain that transmit the sensation of pain throughout the body. The drug works to:
- increase tolerance to pain
- decrease discomfort
- cause sedation
- depress breathing
Codeine can be used alone or in combination with Tylenol or aspirin for more effective pain relief. In addition to being used as a pain medication, codeine is also commonly used to treat diarrhea and diarrhea predominant irritable bowel syndrome.
Codeine Birth Defects
A new study conducted by the CDC analyzed the use of codeine and other opioid drugs in expecting mothers during the first trimester of pregnancy, and found a significantly increased risk of giving birth to babies with the following adverse congenital abnormalities:
- Heart Defects
- Hypoplastic Left Heart Syndrome (HLHS)
- Ventricular Septal Defects (VSDs)
- Atrial Septal Defects (ASDs)
- Tetralogy of Fallot (ToF)
- Right Ventricular Outflow Tract Obstructions (RVOTOs)
- Pulmonary Valve Stenosis
- Gastroschisis (herniation of the abdominal wall)
- Spina Bifida
The new research, which is set to be published in a forthcoming edition of the American Journal of Obstetrics and Gynecology, is the largest ever to focus on the maternal use of opioids during pregnancy. The results of the study are particularly troubling due to the fact that painkillers like codeine were previously thought to be safe for pregnant women to use.
Codeine Heart Defects
Congenital heart defects occur when there is an abnormality in any part of the heart that is present at birth. These defects typically begin to manifest themselves in the first trimester of pregnancy, when the heart is still forming. Each year in the United States, approximately 35,000 infants are born with congenital heart defects. Signs and symptoms of a codeine-induced heart defect may include:
- bluish skin color (cyanosis)
- cold hands and feet (extremities)
- poor pulse
- poor suckling and feeding
- pounding heart
- rapid breathing
- shortness of breath
Codeine and Pregnancy
The safety of codeine during pregnancy has not been established by the U.S. Food & Drug Administration (FDA). However, codeine should generally be avoided by pregnant women due to the fact that the drug may cause birth defects. Additionally, small amounts of codeine may be secreted into breast milk, so nursing mothers should not take the drug when breastfeeding a baby.