The effects of codeine on pregnancy outcome: Results from a large population-based cohort study

Nezvalová-Henriksen, Kateřina; Spigset, Olav; Nordeng, Hedvig

doi:10.1016/j.reprotox.2010.12.040

Cited by 11 publications

(13 citation statements)

References 13 publications

(17 reference statements)

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“…In the present study there were little signs of teratogenicity of dextropropoxyphene but a significant effect of codeine. The latter finding contrasts to a Norwegian study [7] based on prospectively ascertained exposure information. A study from the American National Birth Defects Prevention Study [13] found an association between opioid use and a number of specific malformations but the study was retrospective with a possibility of recall bias and also had a high rate of non-responders and has therefore little informative value.…”

Section: Discussioncontrasting

confidence: 78%

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Use of tramadol in early pregnancy and congenital malformation risk

Källén

Reis

2015

Reproductive Toxicology

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Only few studies exist regarding the risk of a teratogenic effect of tramadol when used in early pregnancy. Using the Swedish Medical Birth Register, women (deliveries in 1997-2013) who had reported the use of tramadol in early pregnancy were identified. Maternal characteristics and concomitant drug use were analyzed. Among 1 682 846 women (1 797 678 infants), 1751 (1776 infants) had used tramadol, 96 of the infants had a congenital malformation and 70 of them were relatively severe. The adjusted odds ratio for a relatively severe malformation was 1.33 (95% CI 1.05-1.70). The odds ratios for cardiovascular defects (1.56, 95% CI 1.04-2.29) and for pes equinovarus (3.63, 95% CI 1.61-6.89) were significantly increased. The study suggests a teratogenic effect of tramadol but the risk increase is moderate.Word count: 128.

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Section: Discussioncontrasting

confidence: 78%

“…Although some animal data suggest adverse neurodevelopment outcomes due to opiate exposure in early life, clinical data in humans remains insufficient and inconclusive [4,5]. Nevertheless, the few data available for morphine [6] and codeine [7] do not indicate teratogenic properties when used during the first trimester.…”

Section: Introductionmentioning

confidence: 99%

Use of tramadol in early pregnancy and congenital malformation risk

Källén

Reis

2015

Reproductive Toxicology

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“…Another study led by Yazdy et al [8] reported an increased risk of neural tube defects. In the other hand, a large population-based cohort study in Norway comparing women who had used codeine during pregnancy with those who had not found no significant association between codeine use and survival, congenital malformation or respiratory depression [9].…”

Section: Non-steroidal Anti-inflammatory Drugs (Nsaids)mentioning

confidence: 96%

Complex regional pain syndrome and pregnancy

Campanharo¹,

Filho²,

Lara³

et al. 2017

Clin Obstet Gynecol Reprod Med

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A 37-year-old patient with Complex Regional Pain Syndrome(CRPS) and continuous intrathecal morphine administration presents to prenatal care pregnant with 16 weeks' gestation. Besides CRPS, she has other medical conditions like obesity, migraine and angina, using topiramate and diltiazem.The discussion goes through an overview of CRPS and chronic pain management in pregnancy. In the end, we include a summary and recommendations based on a brief review of the literature.

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“…Leading literature sources on drug safety in pregnancy consider that sporadic use of codeine is safe in pregnancy (13,15), but surprisingly few studies have been conducted on codeine use in pregnancy in therapeutic doses in a population-based sample. In our MoBa sub-study, 1449 women (2.1%) used codeine during pregnancy (98% in a fixed combination of codeine/paracetamol), of whom 627 (0.9%) used it in the first trimester (11,16). No significant difference in the major congenital malformation rate was found between infants exposed to codeine in the first trimester (2.6%) and the unexposed group (3.0%) (adjusted OR 0.8; 95% CI 0.5-1.4) (11,16).…”

Section: Analgesicsmentioning

confidence: 98%

“…In our MoBa sub-study, 1449 women (2.1%) used codeine during pregnancy (98% in a fixed combination of codeine/paracetamol), of whom 627 (0.9%) used it in the first trimester (11,16). No significant difference in the major congenital malformation rate was found between infants exposed to codeine in the first trimester (2.6%) and the unexposed group (3.0%) (adjusted OR 0.8; 95% CI 0.5-1.4) (11,16). Of note, codeine use was associated with both planned and acute caesarean delivery, probably due to the woman's underlying pain condition.…”

Section: Analgesicsmentioning

confidence: 98%

Medication safety in pregnancy – Results from the MoBa study

Nordeng¹,

Ystrøm²,

Eberhard‐Gran³

2014

Nor J Epidemiol

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SUMMARYThis article summarizes the results of several of our studies on medication safety in pregnancy based on the Norwegian Mother and Child Cohort Study (MoBa). Medications investigated include antidepressants, NSAIDs, codeine, triptans, paracetamol and certain herbals. A major advantage of these studies is that MoBa has information on prescribed medications, over-the-counter medications and herbal medications. Moreover, MoBa enables the possibility of including a disease comparison group, and long-term follow-up into childhood. The size of MoBa enables designs like the sibling-design, which offers important advantages over studies comparing unrelated individuals. The possibility of linking MoBa to nationwide registries like the NorPD and the National Patient Registry enables validation of medication exposures and childhood diagnosis. Pharmacoepidemiological studies are vital to our understanding of the safety of medications in pregnancy, but great care must be taken in the analysis and interpretation of observational data to avoid problems of confounding and bias.This is an open access article distributed under the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The effects of codeine on pregnancy outcome: Results from a large population-based cohort study

Cited by 11 publications

References 13 publications

Use of tramadol in early pregnancy and congenital malformation risk

Use of tramadol in early pregnancy and congenital malformation risk

Complex regional pain syndrome and pregnancy

Medication safety in pregnancy – Results from the MoBa study

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