Cleft palate, fused toes: Fentanyl likely causing certain birth defects in newborns

Doctors believe that a group of 10 to 12 babies in the United States born with multiple congenital malformations could be suffering from a new syndrome related to exposure to fentanyl in the womb.

Healthcare professionals from across the country, in a recent report, found the group of babies whose mothers had used fentanyl while pregnant were born with an abnormally small head, short body, and physical birth defects like a cleft palate or fused toes.

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The doctors could not find any common genetic cause for the babies’ condition. However, their mothers admitted that they used street drugs, particularly fentanyl, while they were pregnant, leading the researchers to believe that exposure to the synthetic opioid was the root cause of these abnormalities.

What did the study find?

The study was published by a group of healthcare professionals in Genetics in Medicine Open. “In light of the ongoing fentanyl use epidemic, public health impact of the novel syndrome associated with prenatal fentanyl exposure is likely to be significant,” the authors wrote in the report.

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The research began with the identification and enrollment of six babies who were identified with the potential syndrome at Nemours Children’s Health in Delaware. Additionally, four babies with similar features were found in the US states of California, Massachusetts and Rhode Island, but they were not enrolled.

All the babies were initially believed to have Smith-Lemli-Opitz Syndrome which is a genetic developmental disorder that affects many parts of the body and is caused by a cholesterol metabolism issue which is necessary for normal cell function and brain development.

However, researchers found that the 10 children did not exhibit any features of SLOS or any other syndrome.

Erin Wadman, a genetic counsellor at Nemours, in an interview with NBC News said that the cases were linked in 2022 when she was asked to consult in the case of a baby who had been born with birth defects.

It was during the appointment that she was able to link all the aspects, including the features of the child and the story of her past patients. “I was sitting there in the appointment, and I was just like this face looks so familiar. This story sounds so familiar. And I was just thinking about how this patient reminded me so much of a patient I'd seen earlier in the year,” Wadmen said, as quoted by NBC News.

She added, “That’s when we were like we think we might have stumbled on something really big here.”

'Critical importance'

Eventually, Wadman and her colleague at Nemours, Dr Karen Gripp, a geneticist and paediatrician suspected that fentanyl may be causing similar disruptions to cholesterol metabolism during pregnancy.

“Although fentanyl’s effect on cholesterol metabolism has not been directly tested, based on indirect evidence it is biologically plausible that it affects cholesterol metabolism in the developing fetus,” the authors wrote.

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The researchers also acknowledged the gaps in their report including “lack of quantifiable prenatal drug exposure and lack of laboratory evidence directly showing fentanyl’s effect on cholesterol metabolism and embryological development”.

However, they said that the recognition of the novel syndrome linked with prenatal fentanyl exposure is of “critical importance”.

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. In 2022, US officials seized enough fentanyl to kill every American as the country continues to struggle with an epidemic of drug overdose deaths.

(With inputs from agencies)