Prescription opioid use during pregnancy and risk for preterm birth or term low birthweight


  • Julia D. Interrante, MPH
  • Stacey L. P. Scroggs, PhD
  • Carol J. Hogue, PhD
  • Jan M. Friedman, MD
  • Jennita Reefhuis, PhD
  • Michael W. Jann, PharmD
  • Cheryl S. Broussard, PhD
  • National Birth Defects Prevention Study



analgesics, opioid, infant, low birthweight, pregnancy, premature birth


Objective: Examine the relationship between prescription opioid analgesic use during pregnancy and preterm birth or term low birthweight.

Design, setting, and participants: We analyzed data from the National Birth Defects Prevention Study, a US multisite, population-based study, for births from 1997 to 2011. We defined exposure as self-reported prescription opioid use between one month before conception and the end of pregnancy, and we dichotomized opioid use duration by 7 days and >7 days.

Main outcome measures: We examined the association between opioid use and preterm birth (defined as gestational age <37 weeks) and term low birthweight (defined as <2500 g at gestational age 37 weeks).

Results: Among 10,491 singleton mother/infant pairs, 470 (4.5 percent) reported opioid use. Among women reporting opioid use, 236 (50 percent) used opioids for > 7 days; codeine (170, 36 percent) and hydrocodone (163, 35 percent) were the most commonly reported opioids. Opioid use was associated with slightly increased risk for preterm birth [adjusted odds ratio, 1.4; 95 percent confidence interval, 1.0, 1.9], particularly with hydrocodone [1.6; 1.0, 2.6], meperidine [2.5; 1.2, 5.2], or morphine [3.0; 1.5, 6.1] use for any duration; however, opioid use was not significantly associated with term low birthweight.

Conclusions: Preterm birth occurred more frequently among infants of women reporting prescription opioid use during pregnancy. However, we could not determine if these risks relate to the drug or to indications for use. Patients who use opioids during pregnancy should be counseled by their practitioners about this and other potential risks associated with opioid use in pregnancy.


Author Biographies

Julia D. Interrante, MPH

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee

Stacey L. P. Scroggs, PhD

New Mexico State University, Las Cruces, New Mexico

Carol J. Hogue, PhD

Rollins School of Public Health, Emory University, Atlanta, Georgia

Jan M. Friedman, MD

Department of Medical Genetics and Genomics, University of British Columbia, Vancouver, British Columbia, Canada

Jennita Reefhuis, PhD

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia

Michael W. Jann, PharmD

University of North Texas Health Science Center, Fort Worth, Texas

Cheryl S. Broussard, PhD

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia


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How to Cite

Interrante, MPH, J. D., S. L. P. Scroggs, PhD, C. J. Hogue, PhD, J. M. Friedman, MD, J. Reefhuis, PhD, M. W. Jann, PharmD, C. S. Broussard, PhD, and N. B. D. Prevention Study. “Prescription Opioid Use During Pregnancy and Risk for Preterm Birth or Term Low Birthweight”. Journal of Opioid Management, vol. 17, no. 3, July 2021, pp. 215-2, doi:10.5055/jom.2021.0632.