(Date of issue: May 2016. Version: 2)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
What is it?
Oxycodone is a medicine that is prescribed to treat moderate to severe pain. Oxycodone is also occasionally used as a recreational drug, often at doses higher than those used to treat pain.
Is it safe to take oxycodone in pregnancy?
Recreational use of oxycodone in pregnancy is not advised as there is no benefit to the health of the mother or baby in this context. If you are pregnant and use oxycodone recreationally it is important that your doctor or midwife is aware of this. If necessary, they will be able to get you help and support to safely stop using oxycodone.
However, it is important to appropriately treat pain in pregnancy. For some women with moderate or severe pain, treatment with oxycodone in pregnancy might be considered the best option for the wellbeing of both mother and fetus. If you are deciding whether to use oxycodone during pregnancy it is therefore important to weigh up how necessary oxycodone is to your health against any possible risks to you or your baby, some of which might depend on how many weeks pregnant you are.
This leaflet summarises the scientific studies relating to the effects of oxycodone on a baby in the womb. Your doctor is the best person to help you decide what is right for you and your baby.
Can taking oxycodone in pregnancy cause my baby to be born with birth defects?
A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.
Three small studies have been carried out that together include 367 babies born to women who used oxycodone to treat pain in early pregnancy. None of these studies showed that babies born to women using oxycodone were more likely to have a birth defect than babies of women not taking oxycodone. These studies did not investigate whether oxycodone use in pregnancy might increase the chance of particular birth defects.
One study which investigated specific malformations following exposure to oxycodone in early pregnancy showed no link with heart malformations or hypospadias (where the opening of the penis is on the underside rather than at the tip). A further study showed a possible link between oxycodone exposure in early pregnancy and pulmonary valve stenosis (narrowing of the valve that controls blood flow from the heart to the lungs) in the baby. Because all of the information about specific malformations was from single studies which only included small numbers of women who were treated with oxycodone in pregnancy, more research is required to confirm these findings.
Can taking oxycodone in pregnancy cause miscarriage?
A single, small study of 78 women using oxycodone to treat pain in early pregnancy showed that they were no more likely to have a miscarriage than pregnant women not using oxycodone. Further larger studies are required to confirm this finding.
Can taking oxycodone in pregnancy cause stillbirth?
No studies have investigated whether rates of stillbirth are increased in women who take oxycodone in pregnancy.
Can taking oxycodone in pregnancy cause the baby to be small at birth (low birth weight), or preterm birth?
No studies have investigated whether babies of women who take oxycodone in pregnancy to treat pain are more likely to have a low birth weight baby (weighing less than 2,500 g) or a preterm delivery (before 37 weeks of pregnancy). A single, small study of 61 women taking oxycodone recreationally during pregnancy suggested that use increased the chance of preterm birth but not of having a low birth weight baby. However, other lifestyle factors that are often more common in women using recreational drugs (such as smoking, alcohol use, and poor nutrition) have been linked to preterm birth and may therefore explain this finding. Large, well-designed studies of women taking oxycodone to treat pain are required before we can say whether use of oxycodone in pregnancy increases the risk of low birth weight in the baby and preterm birth.
Can taking oxycodone in pregnancy cause other health problems in the baby/child?
Withdrawal symptoms at birth
Withdrawal symptoms are thought to occur as the newborn baby’s body has to adapt to no longer getting certain types of medicines through the placenta.
There are reports of individual babies in the scientific literature who had withdrawal symptoms after being exposed to oxycodone in the womb. If you have taken oxycodone regularly in pregnancy it is important to let your doctor or midwife know as it might be advisable that your baby is born in a unit with facilities to monitor and treat withdrawal symptoms if necessary.
Learning and behavioural problems in the child
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.
There are currently no scientific studies that have examined learning and behaviour in children of women who took oxycodone during pregnancy. Research into this subject is therefore required.
What if I have already taken oxycodone during pregnancy?
If you have taken any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and to make sure that you are taking the lowest dose that works.
Will my baby need extra monitoring during pregnancy or after delivery?
Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine antenatal care. Using oxycodone in pregnancy is not expected to cause problems that would require extra monitoring of your baby during pregnancy. However, women with some of the underlying conditions that oxycodone can be used to treat might be more closely monitored to ensure that their baby is growing and developing as expected. Women who use oxycodone recreationally might also receive extra monitoring.
Babies born to women who have taken oxycodone in late pregnancy might be closely monitored after birth to ensure that they are not experiencing withdrawal symptoms.
Are there any risks to my baby if the father has taken oxycodone?
No studies have specifically investigated whether oxycodone taken by the father can harm the baby through effects on the sperm, however most experts agree that this is very unlikely. More research on the effects of medicine use in men around the time of conception is needed.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.