{"id":2266,"date":"2021-02-19T00:00:00","date_gmt":"2021-02-19T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/"},"modified":"2023-06-14T19:45:13","modified_gmt":"2023-06-14T23:45:13","slug":"prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/","title":{"rendered":"Prenatal opioid analgesics and the risk of adverse birth outcomes"},"content":{"rendered":"<p><strong>Background <\/strong>&#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid analgesic exposed pregnancies.<\/p>\n<p><strong>Methods <\/strong>&#x2014; Using universal coverage health data for Ontario, we assembled a cohort of mother-infant pairs without opioid use disorder (627,172 pregnancies, 509,522 women). We estimated risk ratios between opioid analgesics and preterm birth, SGA birth, and stillbirth; neonatal abstinence syndrome was a secondary outcome. We used high dimensional propensity scores and sensitivity analyses for confounding adjustment.<\/p>\n<p><strong>Results <\/strong>&#x2014; 4% of pairs were exposed, mainly to codeine (2%), morphine (1%), and oxycodone (1%). Compared with unexposed, the adjusted risk of preterm birth was higher with any (1.3, 95% CI 1.2, 1.3), first- (RR 1.2, 95% CI:1.2, 1.3), and second-trimester (RR 1.3, 95% CI:1.2, 1.4) opioid analgesic exposure. Preterm birth risk was higher for first- and second-trimester codeine, morphine, and oxycodone exposure, and for third-trimester morphine. There was a small increase in SGA with first-trimester exposure to any opioid analgesic or to codeine. Exposed pregnancies had an elevated stillbirth risk with any (RR 1.6, 95% CI: 1.4, 1.8), first- and second-trimester exposure. Few infants had neonatal abstinence syndrome (N=143); the risk was higher in exposed (RR 3.6, 95% CI: 2.1, 6.0). In sensitivity analyses of unmeasured confounding, an elevated risk in exposed pregnancies persisted for preterm birth but not SGA.<\/p>\n<p><strong>Conclusions <\/strong>&#x2014; Opioid analgesic exposed pregnancies had a small increased risk of preterm birth and possibly stillbirth after accounting for confounding by indication and sociodemographic factors.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid analgesic exposed pregnancies. Methods &#x2014; Using universal coverage health data for Ontario, we assembled a cohort of mother-infant pairs without opioid use disorder (627,172 pregnancies, 509,522 women). We estimated risk ratios [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2266","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Brogly SB, Velez MP, Werler MM, Li W, Camden A, Guttmann A. <em>Epidemiology<\/em>. 2021; 32(3):448-56. Epub 2021 Feb 19.","source_url":"https:\/\/doi.org\/10.1097\/EDE.0000000000001328","ices_scientist":[1168,1238,1114],"site":[6736],"research_program":[6740],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"891C215F-4202-4461-AF81-7C6CF9087DA0","sitecore_item_name":"Prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes","sitecore_field_values":"{\n  \"Title\": \"Prenatal opioid analgesics and the risk of adverse birth outcomes\",\n  \"Short title\": \"Prenatal opioid analgesics and the\",\n  \"Summary\": \"It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid analgesic exposed pregnancies.\",\n  \"Citation\": \"<p>Brogly SB, Velez MP, Werler MM, Li W, Camden A, Guttmann A. <em>Epidemiology<\/em>. 2021; 32(3):448-56. Epub 2021 Feb 19. DOI: <a href=\"https:\/\/doi.org\/10.1097\/EDE.0000000000001328\" title=\"opens external link\">https:\/\/doi.org\/10.1097\/EDE.0000000000001328<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background <\/strong>&mdash; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid analgesic exposed pregnancies.<\/p>n<p><strong>Methods <\/strong>&mdash; Using universal coverage health data for Ontario, we assembled a cohort of mother-infant pairs without opioid use disorder (627,172 pregnancies, 509,522 women). We estimated risk ratios between opioid analgesics and preterm birth, SGA birth, and stillbirth; neonatal abstinence syndrome was a secondary outcome. We used high dimensional propensity scores and sensitivity analyses for confounding adjustment.<\/p>n<p><strong>Results <\/strong>&mdash; 4% of pairs were exposed, mainly to codeine (2%), morphine (1%), and oxycodone (1%). Compared with unexposed, the adjusted risk of preterm birth was higher with any (1.3, 95% CI 1.2, 1.3), first- (RR 1.2, 95% CI:1.2, 1.3), and second-trimester (RR 1.3, 95% CI:1.2, 1.4) opioid analgesic exposure. Preterm birth risk was higher for first- and second-trimester codeine, morphine, and oxycodone exposure, and for third-trimester morphine. There was a small increase in SGA with first-trimester exposure to any opioid analgesic or to codeine. Exposed pregnancies had an elevated stillbirth risk with any (RR 1.6, 95% CI: 1.4, 1.8), first- and second-trimester exposure. Few infants had neonatal abstinence syndrome (N=143); the risk was higher in exposed (RR 3.6, 95% CI: 2.1, 6.0). In sensitivity analyses of unmeasured confounding, an elevated risk in exposed pregnancies persisted for preterm birth but not SGA.<\/p>n<p><strong>Conclusions <\/strong>&mdash; Opioid analgesic exposed pregnancies had a small increased risk of preterm birth and possibly stillbirth after accounting for confounding by indication and sociodemographic factors.<\/p>\",\n  \"Research Programs\": \"{46DF28D2-EDE8-4DF2-8CC0-87CEF464E435}\",\n  \"ICES Locations\": \"{5A12C65D-3CDA-413E-BC94-C1D778156CE6}\",\n  \"ICES Scientists\": \"{64579365-C01D-4F5C-81E8-7A5ECC8B20D3}|{DF9D6D4F-1B33-4FB9-AD9B-576798163C2C}|{8BA6AB62-6906-491D-B4A2-E9F95F8EEB57}\",\n  \"Posted Date\": \"20210219T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2021\/February\/Prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Prenatal opioid analgesics and the risk of adverse birth outcomes<\/title>\n<meta name=\"description\" content=\"Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Prenatal opioid analgesics and the risk of adverse birth outcomes\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:45:13+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\\\/\",\"name\":\"ICES | Prenatal opioid analgesics and the risk of adverse birth outcomes\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2021-02-19T05:00:00+00:00\",\"dateModified\":\"2023-06-14T23:45:13+00:00\",\"description\":\"Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Prenatal opioid analgesics and the risk of adverse birth outcomes\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Prenatal opioid analgesics and the risk of adverse birth outcomes","description":"Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Prenatal opioid analgesics and the risk of adverse birth outcomes","og_description":"Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-14T23:45:13+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/","name":"ICES | Prenatal opioid analgesics and the risk of adverse birth outcomes","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2021-02-19T05:00:00+00:00","dateModified":"2023-06-14T23:45:13+00:00","description":"Background &#x2014; It is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prenatal-opioid-analgesics-and-the-risk-of-adverse-birth-outcomes\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Prenatal opioid analgesics and the risk of adverse birth outcomes"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/2266","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6740"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6736"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1114"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1238"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1168"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=2266"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=2266"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=2266"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=2266"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=2266"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}