Opioid Analgesic Exposure During the First Trimester of Pregnancy and the Risk of Major Congenital Malformations in Infants: A Systematic Review and Meta-analysis

( Anaesthesia . 2024;79(9):967-977. doi: 10.1111/anae.16307) Though pregnancy induces many symptoms that increase discomfort, both patients and providers often hesitate to use analgesics or other medications due to concerns about fetal safety. As some medications have been shown to affect fetal development and/or health, limiting available pain management strategies. It is still unclear whether opioid analgesics are related to major congenital malformations due to ethical and legal concerns surrounding research in this area as well as challenges regarding sample size and statistical power for rare outcomes. This study sought to assess available evidence on the risk of major congenital malformations in infants following first trimester exposure to any opioid analgesic as well as to individual opioids.