Pregnancy Use of Prescribed Opioids Not Significantly Linked to Autism or ADHD Risk

Recent research suggests that using prescribed opioid pain medications during pregnancy does not substantially increase the risk of neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children. Although previous studies observed higher rates of these conditions among children exposed to opioids in utero, new analysis indicates that these associations may be influenced by other genetic and environmental factors rather than the opioid exposure itself.

The study, conducted by Emma N. Cleary and colleagues and published in PLOS Medicine, examined over 1.2 million children born in Sweden between 2007 and 2018 for autism and over 900,000 children born between 2007 and 2015 for ADHD. Researchers analyzed the relationship between the dosage and duration of opioid use during pregnancy and the likelihood of the children being diagnosed later. While initial data showed higher percentages of diagnoses in children exposed to opioids—2.9% with low doses and 3.6% with high doses for ASD, and similar trends for ADHD—further statistical analysis that accounted for confounding factors eliminated these disparities.

The team noted that their data did not include information on extremely high doses or prolonged use, which are less common due to Swedish prescribing practices. Nonetheless, findings indicate that at the studied levels, prescribed opioids are unlikely to cause a significant increase in autism or ADHD risk.

These results are essential for pregnant individuals and healthcare providers making decisions regarding pain management. The authors emphasize that the observed links between prenatal opioid exposure and neurodevelopmental disorders are probably driven by other pre-existing factors. The study advocates for comprehensive pain management strategies that include psychosocial support and safe, evidence-based treatments to ensure both maternal comfort and fetal health.

While caution is advised in cases of very high doses, overall, the evidence suggests that prescribing opioids during pregnancy does not have a causal relationship with autism or ADHD development in children, providing reassurance for clinical decision-making. The researchers hope their findings will support balanced approaches to managing pain in expectant mothers, considering both physical comfort and developmental safety.