In a troubling development, an alarming number of babies in the US are being born with a new and disturbing condition associated with fentanyl use during pregnancy.
This condition, known as fetal fentanyl syndrome, leads to severe physical and neurological defects, including conjoined fingers and toes and abnormal head shapes.
Dr. Miguel Del Campo from Rady Children’s Hospital in San Diego has encountered 20 cases of this syndrome and worries that the actual number of affected infants could be much higher and possibly going undiagnosed.
The condition was first identified last fall, but there’s still no comprehensive data at either the national or state level to understand its prevalence.
Dr. Del Campo’s concerns are based on recent research from Vanderbilt University, the University of Nebraska Medical Center, and Nemours Children’s Hospital in Delaware.
He said, “After reading the paper and reflecting on it, I realized the potential impact of fentanyl exposure.”
Understanding the Impact
Fentanyl exposure in the womb is thought to interfere with the baby’s ability to produce cholesterol, which is essential for proper brain and body development.
Babies with this syndrome often have a cleft palate, abnormally shaped feet (referred to as “rocker bottom feet”), upturned noses, drooping eyelids, smaller lower jaws, and webbed toes. Dr. Del Campo has reported identifying 20 such cases.
He expressed his concern, noting, “I fear that this is not rare, and I worry that many children are going unrecognized.”
The Broader Crisis
The situation is becoming more dire as fentanyl continues to drive a surge in overdose deaths.
The rates of fatal overdoses related to fentanyl have skyrocketed, tripling from 2016 to 2021.
Fentanyl is often mixed with other drugs like cocaine and ecstasy, sometimes without the users’ knowledge.
There is still a need for more concrete evidence to definitively link fentanyl to these birth defects.
The National Institutes of Health (NIH) had previously stated that, based on existing studies, fentanyl exposure was not expected to increase the risk of birth defects beyond the general background risk.
However, fentanyl has been shown to cross the placenta, the organ that supplies oxygen and nutrients to the fetus, which raises concerns.
Research Developments
Recent studies have found fentanyl in fetal brain tissue, suggesting that the drug transfers quickly to the fetus early in pregnancy and remains in fetal tissues for an extended period.
Despite these findings, the NIH has stated that a specific pattern of birth defects caused by opioids like fentanyl has not been conclusively established.
Last year, researchers in Delaware and other states including California, Boston, and Rhode Island, reported identifying 10 babies with similar defects believed to be linked to fetal fentanyl syndrome.
This study was separate from the research conducted by Vanderbilt scientists.
The Vanderbilt team compared fetal fentanyl syndrome to a genetic disorder called Smith-Lemli-Opitz Syndrome (SLOS), which affects cholesterol production due to two faulty genes.
They found that fetuses with just one of these genes might be more vulnerable to the birth defects associated with fentanyl exposure.
Ned Porter, a research professor at Vanderbilt, commented, “Fentanyl not only disrupts cholesterol synthesis but also leads to the accumulation of toxic sterols found in SLOS patients.
This compound’s presence during fetal development likely plays a significant role in these syndromes.”
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