Prolonged use of opioids during pregnancy can result in physical dependence in the neonate and neonatal opioid withdrawal syndrome shortly after birth. The onset, duration, and severity of the condition will vary based on use (duration of use, timing, and amount of last maternal use) and rate of elimination in the newborn. During the third trimester of pregnancy, salicylate administration may inhibit prostaglandin synthesis causing constriction of the ductus arteriosus resulting in pulmonary hypertension. Aspirin use during pregnancy may cause alterations in maternal and neonatal hemostasis. There are no controlled data in human pregnancy.

Chronic use of opioids may cause reduced fertility; it is unknown whether these effects are reversible.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

Not recommended, especially during last trimester of pregnancy

US FDA pregnancy category: Not Assigned

Comments:
-Avoid use during third trimester as it may cause premature closure of the ductus arteriosus.
-Prolonged use of opioids during pregnancy can result in physical dependence in the neonate; women should be advised of the risk of neonatal abstinence syndrome and ensure that appropriate treatment will be available.
-Monitor neonates exposed to opioid analgesics during labor for signs of excess sedation and respiratory depression.

Not recommended

Excreted into human milk: Yes

Comments:
-If used, monitor breastfed infants for excess sedation and respiratory depression.
-Withdrawal symptoms may occur in breastfed infants when maternal administration of an opioid is stopped or when breast-feeding is stopped.

Maternal use of narcotics during breastfeeding can cause infant drowsiness, central nervous system depression, and even death. Infant sedation is common with maternal use of oxycodone. Newborn infants are particularly sensitive to the effects of even small dosages of narcotic analgesics. Adverse effects on platelet function are possible when nursing infants are exposed to aspirin; the risk of Reye Syndrome caused by salicylate in breast milk is unknown.