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Aotearoa New Zealand has emerged as having the third highest rate of prescribed opioid use during pregnancy among 13 high-income countries, according to a new multinational study published in the journal Anesthesiology. The research, led by the University of New South Wales and including data from over 20 million pregnancies between 2000 and 2020, raises concerns about the health risks for both mothers and babies.
Key Findings
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Prevalence: Nearly 8% of pregnancies in New Zealand involved prescribed opioid use, surpassed only by the United States and Iceland. By comparison, only 4% of pregnancies in Canada and 0.4% in the UK involved opioid prescriptions.
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Opioid Types: The most commonly prescribed opioids were codeine and tramadol.
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Demographics: Opioid use during pregnancy was more frequent in the later stages, and among individuals with lower incomes and higher body mass index (BMI).
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Trends: While opioid use remained stable or declined in most countries, overall prescription medication use during pregnancy increased over the 20-year period studied.
Expert Insights
Dr. Sarah Donald, co-author from the University of Otago, expressed surprise at the high rates in New Zealand and called for a review of national guidelines. “The risks of opioid use need to be better considered, especially given the significant between-country variation,” she said.
Professor Lianne Parkin, another co-author, highlighted the potential dangers: “Opioids cross the placenta, exposing the fetus. Use during early pregnancy may increase the risk of certain congenital malformations, and can also lead to preterm birth, low birth weight, breathing problems, withdrawal symptoms in newborns, and longer-term neurodevelopmental conditions.”
Calls for Further Research
The study’s authors noted that while the reasons for increased opioid use in pregnancy are not fully understood, factors may include an aging population of pregnant individuals and a greater recognition of the need to treat pain during pregnancy. Encouragingly, about 80% of those prescribed opioids during pregnancy received only a single prescription.
Implications for Healthcare Policy
The findings suggest a need for New Zealand health authorities to re-examine prescribing practices and guidelines for opioid use in pregnancy. The authors urge careful consideration of the risks and benefits when treating moderate or severe pain in pregnant patients.
Disclaimer:
This article summarizes findings from a recent scientific study and is intended for informational purposes only. It does not constitute medical advice. Pregnant individuals or those planning pregnancy should consult healthcare professionals before starting or stopping any medication, including opioids. For more information, see the original study: Jonathan Brett et al, Anesthesiology (2025), DOI: 10.1097/ALN.0000000000005418.
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