OPIUM

Fetal Risk Summary

The effects of opium are caused by morphine (see Morphine). The Collaborative Perinatal Project monitored 50,282 mother-child pairs, 36 of which had 1st-trimester exposure to opium (1, pp. 287–295). For use anytime during pregnancy, 181 exposures were recorded (1, p. 434). Four of the 1st-trimester exposed infants had congenital defects, but these numbers are too small to draw any conclusion about a relationship between the drug and major or minor malformations. A possible association with inguinal hernia based on seven cases after anytime exposure was suggested (1, p. 485) (see also Morphine for similar findings). The statistical significance of these associations is unknown and independent confirmation is required.

Narcotic withdrawal was observed in a newborn whose mother was treated for regional ileitis with deodorized tincture of opium during the 2nd and 3rd trimesters (2). Symptoms of withdrawal in the infant began at 48 hours of age.

[*Risk Factor D if used for prolonged periods or in high doses at term.]

Breast Feeding Summary

See Morphine.

References

1. Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977.
2. Fisch GR, Henley WL. Symptoms of narcotic withdrawal in a newborn infant secondary to medical therapy of the mother. Pediatrics 1961;28:852–3.