Cleft palates, fused toes, abnormally small heads, and short bodies are some of the common symptoms found in children born to women who used fentanyl while pregnant, according to a new study.
The study, which was published in Genetics in Medicine Open, looked at 10 infants who were exposed to both prescription and illegal drugs in the womb. Six infants were identified at Nemours Children’s Health in Wilmington, Delaware; two were from California; one from Massachusetts; and one from Rhode Island.
The babies were exposed to amphetamine, alcohol, cocaine, clonazepam (a medication used to prevent and control seizures), gabapentin, fentanyl, heroin, marijuana, methadone, opiates, and Xanax. Every child was exposed to fentanyl in the womb and tested positive for the drug after birth.
Each birth was marred by individual and shared complications, researchers found. Across the board, the infants failed to meet standard growth parameters and had difficulty feeding. For example, a female baby exhibited motor delay and was unable to roll over at 6 months. Another male child was hitting the milestones for a 4-month-old, such as smiling socially and tracking people with his eyes, grasping for objects, and rolling over, when he was 6 months old.
The 10 children shared distinct facial and other physical features, including a cleft palate, adducted thumb, fused toes, and a singular palmar crease when most people have three.
Additionally half of the infants were born with a cleft palate and two-thirds had genital abnormalities. Other issues included problems with brain development, specifically the failure of the corpus callosum to fully develop. The corpus callosum is some of the innermost part of the brain, or the white matter that connects the left and right cerebral hemispheres. Lastly, researchers noted high levels of enzymes responsible for making cholesterol in the body.
At the start of the study, the health care professionals involved in analyzing the babies believed they suffered from Smith-Lemli-Opitz Syndrome (SLOS), a genetic disorder that affects how cholesterol is produced in the body. Without adequate cholesterol levels during embryonic development, a baby can be born with distinct facial features, a small head, and learning and behavioral problems, which are all similar characteristics to the children in the study, researchers noted.
But through more analysis, researchers determined the children did not exhibit any of the exact classic features of SLOS patients, which also include heart, lung, kidney, and gastro-intestinal tract malformations. They also lacked the genetic mutation that caused SLOS.
The researchers also did not believe the children showed signs of any other syndrome related to babies exposed to drugs in the womb. Rather, the physicians involved in the study believe they have established a “novel syndrome” with working criteria that will be able to be used for future diagnoses for babies who have been exposed to fentanyl in the womb.
“In patients with findings consistent with the novel syndrome, or with a suspected SLOS diagnosis … maternal use of fentanyl during the pregnancy should be inquired about or documented if information is available,” Erin Wadman, lead researcher, wrote in the study.
Why This Matters
Fentanyl is a synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine. Pharmaceutical fentanyl is sometimes prescribed for advanced-stage cancer patients and to treat severe pain. It is a powerful and addictive drug that kills 150 people every day from overdoses. The Centers for Disease Control and Prevention (CDC) estimates that millions of Americans currently suffer from opioid addiction, including pregnant women.
The CDC notes that birth defects can occur during any stage of pregnancy, with the risk of defects increasing if the mother smokes, drinks alcohol, or takes certain drugs during pregnancy. They’re also common, with one in every 33 babies born in the United States having some kind of birth defect.
Prior to the study, the best information available to the public about fentanyl use during pregnancy noted that using the opioid while pregnant can cause fetal distress, may increase the risks of birth defects, and will likely cause neonatal abstinence syndrome once the baby is born. This is another way to say that a newborn baby will experience withdrawals from the drug it received in utero. For opioid withdrawals, the newborn will likely experience trouble breathing, extreme drowsiness, poor feeding, irritability, sweating, tremors, vomiting, and diarrhea.