Opioid use linked to pregnancy loss, lower chance of conception: NIH study

Of the 1,228 women in the study, 226 (18%) had used opioids while trying to conceive and 33 (5%) of 685 women who became pregnant had used opioids in early pregnancy. None tested positive for methadone or buprenorphine, typically used to treat opioid dependence.

Opioid use before conception was associated with a 29% lower chance of achieving pregnancy during a given monthly cycle, compared to women who had not used opioids. Among the women who became pregnant, those who used opioids around the time of conception were 1.5 times as likely to have a miscarriage as women who had not. Women who used opioids in the first four weeks of pregnancy were more than twice as likely to have a miscarriage. Women who used opioids in weeks four through eight of pregnancy were 2.5 times as likely to have a miscarriage.

The authors called for additional research on how opioid use affects fertility and early pregnancy. They added that until more is known, patients and physicians should evaluate the potential risks and benefits of opioids for pain management among women who are pregnant or may become pregnant, including those undergoing assisted reproduction procedures that may involve opioid treatment to manage pain.

Reference:

Flannagan, KS et al. Is opioid use safe in women trying to conceive?Epidemiology. 2020.