More Babies Are Born with the Intestine Outside the Body. What are the conditions related to the use of maternal opioids?


The rate of serious birth defects is increasing in the United States, and a new report shows that the condition may be related to opioid use.

The report, published January 17 by researchers at the Centers for Disease Control and Prevention, looked at the case of gastroschisis, a birth defect in which babies are born with their intestines outside the body, due to holes in the abdominal wall. Surgery is needed to restore the intestine to the body and to repair the hole, but even after this treatment, the baby may have problems with digestion, eating and absorption of food, according to the CDC. The cause of this condition is usually unknown, but mothers aged under 20 years are considered to be at higher risk than older mothers.

The new report analyzed information on gastroschisis cases in 20 US states and found that gastroschisis levels increased 10 percent from 2006 to 2010, until 2011 to 2015. In particular, the report found that gastroschisis rates rose from 4.2 cases per 10,000 live births in 2006 to 2010, to 4.5 cases per 10,000 live births in 2011 to 2015. The largest increase was seen in babies born to mothers in their 20s and 30s. [7 Baby Myths Debunked]

The new report follows a previous study which found that gastroschisis levels also increased between 1995 and 2012.

The reason for this increase is unknown, but the new report suggests a link to the opioid epidemic. The researchers found that the prevalence of gastroschisis was 1.6 times higher in countries with high levels of prescription opioid use, compared with countries with low levels of prescription opioids.

However, the researchers noted that this study only found a connection, and could not prove that the use of opioids caused gastroschisis. This study examined opioid use and gastroschisis levels only at the population level, and had no information about whether women who had babies with gastroschisis were exposed to opioids.

Saima Aftab, medical director of the Fetal Care Center at Nicklaus Children's Hospital in Miami, who was not involved in the study, said that the increase in gastroschisis incidence was alarming. And the fact that the rate of increase is not only in women under 20, who are considered high risk, but also in the older age group "is even more worrying," Aftab told Live Science. This shows that "something has changed" about the usual epidemiological patterns of gastroschisis.

Aftab noted that he and his colleagues had also noticed an increase in gastroschisis cases in their hospital fetal programs, even in the past six months.

Gastroschisis is a serious condition that can cause swelling, bending and damage to the baby's intestine before birth, Aftab said. Even after surgery, it may take weeks for the intestine to begin functioning, and the baby may be in the neonatal intensive care unit (NICU) for months, he said.

The link to opioids seen in the new report is an interesting signal, Aftab said, although he also warned that the report could not determine causal relations.

But "it does guide where we need to direct our research and how we can answer these questions," he said. For example, basic science studies in animals can see whether opioids interfere with intestinal blood vessels or tissues when consumed during pregnancy. And the researchers can also see if there is a relationship between the high-risk population of women using opioids in pregnancy.

"Having a better understanding of all the possible effects of opioid use during pregnancy can help provide health care providers and women with evidence-based information about the potential risks to the developing fetus," the report concluded.

Initially published on Direct Science.


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