Fentanyl exposure in utero causes birth defects in newborns, doctors warn

Severe birth defects have become increasingly common as new research points to fentanyl abuse as a possible new cause.

Recently, at least 30 babies across the US have been born with “fetal fentanyl syndrome,” NBC News reported Friday — a rare condition caused by mothers using the street drug during pregnancy.

“I have identified 20 patients,” told NBC Dr. Miguel Del Campo, a medical geneticist and infant addiction specialist at Rady Children’s Hospital in San Diego. “I’m afraid this is not rare and I’m afraid the children will not be recognized.”

Fetal fentanyl syndrome was first identified by geneticists at Nemours Children’s Health in Wilmington, Delaware, who studied 10 babies with the same physical birth defects, including cleft palates, extremely small heads, droopy eyelids, clubbed toes, mesh and underdeveloped nodes. Some also had problems with food.

Del Campo, who read their report on fetal fentanyl syndrome, had seen similar symptoms in many of his births among mothers who denied drinking alcohol during pregnancy. Fetal alcohol syndrome is known to cause similar characteristics in babies. The children also failed to meet the criteria for a rare genetic condition called Smith-Lemli-Opitz, which prevents brain development in the fetus by interrupting the fetus’s production of cholesterol.

“After reading the paper and thinking about things, I recognized the potential for exposure to fentanyl,” he said.

Del Campo is calling for more research — and fast. “We need to know how these kids are doing. “I have some 2-year-olds that are very disturbing,” he said. “They’re just not growing or developing.”

Dr. Karen Gripp, a geneticist at Nemours, and her team at the University of Nebraska Medical Center were able to detect a link between fentanyl use and cholesterol production in newborns and published their findings in the journal Molecular Psychiatry last month.

“This is not something that people have known before, that fentanyl interferes so significantly with cholesterol metabolism,” Gripp told NBC News. “This is so important because cholesterol must be synthesized as the embryo develops.”

Fentanyl abuse is already a known risk factor for premature and stillbirths, and it can also cause seizures, vomiting, diarrhea and irritability in newborns as they undergo drug detoxification during infancy. Meanwhile, signs of fetal fentanyl syndrome are not commonly associated with addicted mothers.

However, the new study reveals a link between the powerful narcotic drug and Smith-Lemli-Opitz-related birth defects.

For the inherited disease to develop, two copies of the Smith-Lemli-Opitz gene must be present — but fentanyl exposure to cells with just one copy of the gene was enough to induce birth defects associated with the disease.

“Not everyone is equally susceptible,” said study author Dr. Karoly Mirnics, director of the University of Nebraska Medical Center’s Munroe-Meyer Institute, in a press release. “The potential adverse effects of any medication or chemical compound may depend on your genes, lifestyle and environmental factors. A drug may cause me no problems and may be disastrous for you.”

The findings are expected to help detect more cases of fetal fentanyl syndrome.

“The group is growing,” Gripp said. “We anticipate that there will be a lot of patients.”