Pain is a common symptom associated with pregnancy. Pregnant women undergo a series of physiological changes, including weight gain and increased ligamentous laxity. These effects can worsen the pain. Opioids are often prescribed to women during pregnancies, but studies show that they can have adverse effects on the offspring.

 This population-based cohort study included a total of 1,602,580 publicly insured and 1,177,676 commercially insured pregnant women, with pregnancy ranging from three months gestation to one month after delivery. All women were prescribed to any opioids during the first trimester. The primary outcome of the study was major malformations in offspring.

 70,744 publicly insured and 12,454 commercially insured women had two or more dispensations of an opioid. The overall risk of congenital malformations in offspring was 41.0 per 1,000 pregnancies exposed to opioids compared with 32.0 per 1,000 pregnancies unexposed to opioids. After adjustment, the pooled unadjusted relative risk estimates shifted to null. Congenital malformations identified during the study were cardiovascular malformations, ventricular septal defect, atrial septal defect, neural tube defect, and clubfoot.

 The research concluded that prescription opioids used in early pregnancy are not significantly associated with an increased risk of congenital malformations in offspring.