A new study suggests pregnant Americans are taking too many prescription drugs
By M.S.L.J. | ATLANTA
MANY expectant mothers find themselves the victims of friendly advice. Pregnant women seen sipping coffee or alcohol, or sneaking a puff from a cigarette, are often subjected to some uninvited counselling, or at least a few harsh looks. As it turns out, nosy strangers are not completely off-base: a growing body of research shows that a baby's experiences in utero can have long-term consequences (something we reported in depth here). Now a new study finds that even drugs prescribed by a pregnant woman's doctor can seriously harm children in the womb, too.
Research published in the Journal of Perinatology shows that in America in 2012 an infant was born every 25 minutes with neonatal abstinence syndrome (NAS)—a five-fold increase in a decade. This means the babies suffered from the withdrawal of drugs to which they had grown accustomed in the womb. Children born with the syndrome can suffer from seizures, struggle to eat and weigh less than those born without.
The syndrome was first detected in the 1970s among infants born to mothers who used heroin, says Stephen Patrick, one of the study’s authors. But less illicit substances seem to be behind the problem today. Though the data do not account for any illegal substances a mother may be taking, diagnostic and demographic information on millions of newborns from two national databases—the Kid’s Inpatient Database and the Nationwide Inpatient Sample—found that the rise in the number of babies born with withdrawal symptoms mirrors the rise in prescriptions for opioid pain relievers (OPRs). Infants exposed in the womb to long-acting painkillers, where the effects of the pill last up to 12 hours rather than just four, were most likely to develop NAS.
Opioid prescriptions for everything from tooth pain to a back ache have quadrupled in the past decade, says Dr Patrick. In 2012 the total number of such prescriptions rose to 259m—enough for every American adult to have a bottle. Unfortunately these drugs are habit-forming: the Centres for Disease Control and Prevention found that more than 2m Americans were either abusing or addicted to opioids in 2013—the year that Vicodin, one such OPR, was the drug most widely prescribed to Medicare beneficiaries in America (more than 8m patients had Vicodin assigned to them). The paper doesn't address the reasons for the rise in prescriptions directly. But Dr Patrick believes that pain pills were not given out enough in the 1990s, and that medical professionals have now overcorrected the problem after a shift in scientific attitudes in the past decade.
Overall nearly six out of 1,000 babies are born with NAS, but the problem is not distributed equally throughout the country. In central south-eastern states, including Alabama, Mississippi, Tennessee and Kentucky, that number exceeds 16 in 1,000. Doctors are most likely to prescribe short-duration painkillers in these states, too. In New England, where doctors prescribe the most long-acting painkillers, more than 13 in 1,000 infants show signs of NAS. The care needed to help these babies is costly, rising from $731m in 2009 to $1.5 billion by 2012 according to the study. Much of this money comes from public coffers: 80% of babies with NAS receive treatment under Medicaid.
While it is difficult to record accurately all the substances an expectant mother puts into her body, the new paper suggests strong links between pill-popping and sickly children. Further research is now vital to determine how much opioids harm babies, and what can be done to curb America’s growing taste for them.
