The Effects of opioids on female fertility, pregnancy and the breastfeeding mother‐infant dyad: A Review

Abstract

Opioids cover a broad class of natural, synthetic and semi‐synthetic drugs that act on opioid receptors to produce powerful analgesic effects. Rates of opioid use and opioid agonist maintenance treatment have increased substantially in recent years, particularly among women. Trends and outcomes of opioids use on fertility, pregnancy and breastfeeding, and longer‐term child developmental outcomes have not been well‐described. Here, we review the existing literature on the health effects of opioid use on female fertility, pregnancy, breastmilk and the exposed infant. We find that the current literature is primarily concentrated on the impact of opioid use in pregnancy and neonatal outcomes, with little exploration of effects on fertility. Studies are limited in number, some with small sample sizes, and many are hampered by methodological challenges related to confounding and other potential biases. Opioid use is becoming more prevalent due to environmental pressures such as COVID‐19. More research is needed to better elucidate its effects on reproductive health among younger women and support the development of evidence‐based recommendations for safe prescription practices and public health messaging.

Effect of IMB Model Combined with Spousal Support Breastfeeding Intervention on PBSES Score and Breastfeeding Rate of Primipara with Chronic Hepatitis B Virus Infection

“…However, due to the maternal cesarean section postoperative pain, coupled with the lack of understanding of the benefits of exclusive breastfeeding, it is not high enthusiasm for exclusive breastfeeding. Education during pregnancy can promote the rate of postpartum exclusive breastfeeding [ 15 ]. In addition, previous studies show that while the father cannot directly provide milk, but positive attitude, and practice in the whole process of breastfeeding support and emotional encouragement will directly affect the maternal breastfeeding self-efficacy and the higher maternal breastfeeding self-efficacy, tending to the greater the chance of exclusive breastfeeding [ 16 ].…”

Sex- and Gender-Specific Drug Abuse Dynamics: The Need for Tailored Therapeutic Approaches

“…Some of the unique issues women who use drugs face affect their reproductive cycles. Some substances can increase the likelihood of infertility and early onset of menopause [ 91 , 92 ].…”

Simplified processing and rapid quantification of buprenorphine, norbuprenorphine, and their conjugated metabolites in human plasma using UPLC–MS/MS: Assessment of buprenorphine exposure during opioid use disorder treatment

“…4 The use of opioids in pregnancy is a public health issue that might have significant maternal, fetal, and neonatal adverse consequences. 5,6 Pregnant women with OUD are treated with BUP to manage opioid dependence or as an analgesic. 7 BUP is a semi-synthetic, long-acting opioid and possesses unique pharmacological actions through the partial agonist and antagonist effects on mu and kappa opioid receptors, respectively.…”

“…An emergent increase in prescription opioid medications from 18.5% to 22.8% has been reported between 2000 and 2007 in a cohort of Medicaid‐enrolled pregnant women 4 . The use of opioids in pregnancy is a public health issue that might have significant maternal, fetal, and neonatal adverse consequences 5,6 . Pregnant women with OUD are treated with BUP to manage opioid dependence or as an analgesic 7 .…”