Maternal Use of Opiates or Opioid Analgesics and Infant Congenital Malformations
Although there are statements in literature on teratogenic effects of opioids including an increased risk of neural tube defects and of cardiac defects, these are based on retrospective studies of dubious validity. Most prospective data speak in favor of a low teratogenic effect of such drugs—even if unwanted effects of other nature can be obtained, notably after exposure during late pregnancy. It is likely that a weak teratogenic effect of tramadol exists, notably increasing the risk for pes equinovarus, but further data are needed. Also the risk for cardiovascular defects may be increased but again further data are needed. If possible tramadol should be avoided in early pregnancy but if exposure has occurred the individual risk must be regarded as low.
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