Severe birth defects have become increasingly common as new research points to fentanyl misuse as a new possible cause.
Recently, at least 30 infants across the US have been born with “fetal fentanyl syndrome,” NBC News reported on Friday — a rare condition caused by mothers using the street drug while pregnant.
“I have identified 20 patients,” Dr. Miguel Del Campo, a medical geneticist and infant addiction specialist at Rady Children’s Hospital in San Diego told NBC. “I fear that this is not rare, and I fear kids are going unrecognized.”
Fetal fentanyl syndrome was initially defined by geneticists at Nemours Children’s Health in Wilmington, Delaware, who studied 10 babies with the same physical birth defects, including cleft palate, unusually small heads, drooping eyelids, webbed toes and underdeveloped joints. Some also had trouble feeding.
Del Campo, who read their report on fetal fentanyl syndrome, had seen similar symptoms in many of his deliveries among mothers who denied drinking during pregnancy. Fetal alcohol syndrome is known to cause similar features in infants. The children also failed to meet the criteria for a rare genetic condition called Smith-Lemli-Opitz, which hampers brain development in fetuses by disrupting cholesterol production in fetuses.
“After reading the paper and thinking about things, I have recognized the potential for exposure to fentanyl,” he said.
Del Campo is urging for more research — and fast. “We need to know how these kids are doing. I have some 2-year-olds that are very concerning,” 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 uncover 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 had known before, that fentanyl interferes so significantly with cholesterol metabolism,” Gripp told NBC News. “This is so important because cholesterol needs to be synthesized as the embryo develops.”
Fentanyl misuse is already a well-known risk factor for preterm and stillbirths, and may also cause seizures, vomiting, diarrhea and irritability in newborns as they undergo drug detox during infancy. Meanwhile, the signs of fetal fentanyl syndrome are not typically associated with addicted mothers.
However, the new study reveals a connection between the powerful narcotic drug and birth defects associated with Smith-Lemli-Opitz.
For the inherited disease to develop, two copies of the Smith-Lemli-Opitz gene must be present — but fentanyl exposure in cells with just one copy of the gene was enough to prompt birth defects related to the illness.
“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 potentially adverse effects of any medication or chemical compound might depend on your genes, lifestyle and environmental factors. One drug might not cause problems for me and might be catastrophic for you.”
The findings are expected to help uncover increasingly more cases of fetal fentanyl syndrome.
“The group is growing,” Gripp said. “We anticipate that there will be many more patients.”
