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

Corsi, Daniel J; Sq Murphy, Malia

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 evidence 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 its effects on fertility. Studies are limited in number, with small sample sizes, and are hampered by methodological challenges related to confounding and other potential biases. Opioid use is becoming more prevalent. More research is needed to better elucidate its effects on reproductive health among younger women to support the development of evidence-based recommendations for safe prescription practices and public health messaging.