An association between first-trimester use of codeine and congenital heart defects has been found in three of four

casecontrol studies (69). Previous reports have not shown an increase in risks of birth defects after prenatal
exposure to oxycodone, propoxyphene, or meperidine (10, 11). The authors of one retrospective study observed an
increased risk of some birth defects with the use of prescribed opioids by women in the month before or during the
first trimester of pregnancy (12). However, methodological problems with this study exist, and such an association
has not been previously reported. The observed birth defects remain rare with a minute increase in absolute risk.
Although none of these studies investigated methadone or buprenorphine specifically, concern about a potential
small increased risk of birth defects associated with opioid-assisted therapy during pregnancy must be weighed
against the clear risks associated with the ongoing use of illicit opioids by a pregnant woman.

During pregnancy, chronic untreated heroin use is associated with an increased risk of fetal growth restriction,
abruptio placentae, fetal death, preterm labor, and intrauterine passage of meconium (13). These effects may be
related to the repeated exposure of the fetus to opioid withdrawal as well as the effects of withdrawal on placental
function. Additionally, the lifestyle issues associated with illicit drug use put the pregnant woman at risk of engaging in
activities, such as prostitution, theft, and violence, to support herself or her addiction. Such activities expose women
to sexually transmitted infections, becoming victims of violence, and legal consequences, including loss of child
custody, criminal proceedings, or incarceration.

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Ca
re-for-Underserved-Women/Opioid-Abuse-Dependence-and-Addiction-in-Pregnancy
According to a new study published online April 13 in the journal Pediatrics and
conducted using the medical records of more than 112,000 Tennessee pregnant
women, the use of prescription narcotic painkillersincluding drugs like hydrocodone
(brand name Vicodin), oxycodone (brand name Oxycontin), codeine, and
morphinewas common. And it drove up the chances of early delivery, low birth
weight, or even a challenging withdrawal period from the drugs for the baby.
Nearly 30 percent of the moms in the study used at least one of those drugs during her
pregnancy. And the risk of those troubling outcomes for baby went up if the expecting
women were also medicated with antidepressants, or if they smoked
"I was surprised by the number of women prescribed opioid pain relievers in
pregnancy," wrote lead author Dr. Stephen Patrick, a neonatologist and assistant
professor of pediatrics at Vanderbilt University in Nashville. "I was also surprised by how
commonly women smoked in pregnancy, and how much that increased the risk of
neonatal abstinence syndrome [problems faced by babies exposed to drugs in utero]
among those who also used opioid pain relievers in pregnancy."
http://www.parents.com/blogs/everything-pregnancy/2015/04/14/healthy-pregnancy/taki
ng-common-narcotics-in-pregnancy-can-hurt-your-baby/
What problems can opioids cause during pregnancy?
Using opioids during pregnancy can cause problems for your baby, including:

Neonatal abstinence syndrome (also called NAS). NAS happens when a

baby is exposed to a drug in the womb before birth and goes through
withdrawal from the drug after birth. NAS most often is caused when a
woman takes opioids during pregnancy. NAS can cause serious problems
for a baby, like being born too small and having breathing problems.
Even if you use an opioid exactly as your health care provider tells you
to, it may cause NAS in your baby. So tell your prenatal care provider
about any opioid you take, even if its prescribed to you by another
health care provider. If another health care provider prescribes you an
opioid, make sure she knows youre pregnant.
Birth defects, including heart defects. Birth defects are health conditions
that are present at birth. Birth defects change the shape or function of
one or more parts of the body. They can cause problems in overall
health, how the body develops, or in how the body works.
Premature birth. This is birth that happens too early, before 37 weeks of
pregnancy. Babies born early may have more health problems at birth
and later in life than babies born full term.
Preterm labor. This is labor that starts too early, before 37 weeks of
pregnancy. Quitting opioids suddenly (going cold turkey) during
pregnancy can cause preterm labor. Preterm labor can lead to premature
birth.
Stillbirth. This is the death of a baby in the womb after 20 weeks of
pregnancy.

If youre not pregnant and youre using opioids, use effective birth control until
youre ready to get pregnant. This can help prevent complications when you do get
pregnant.

http://www.marchofdimes.org/pregnancy/prescription-opioids-during-pregnancy
.aspx