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New syndrome may be developing in newborns exposed to fentanyl

A new abnormality syndrome may be present in newborns who were exposed to fentanyl while in the womb.
New syndrome may be developing in newborns exposed to fentanyl
Posted at 7:47 PM, Dec 05, 2023

A group of babies born with multiple congenital malformations could be evidence of a new syndrome linked to fentanyl exposure while in the womb.

In a new report, health care professionals from across the U.S. discovered a group of 10 infants, all born to mothers who had used fentanyl while pregnant, were each born with an abnormally small head, short body and distinctively malformed features, like a cleft palate or fused toes.

None of the infants had a shared genetic cause for the abnormalities, which led the researchers to believe the shared factor of prenatal fentanyl use was the root cause.

"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, published in Genetics in Medicine Open. "Prenatal fentanyl exposure should be inquired about in patients with suggestive findings."

The research initially began with six infants from Delaware's Nemours Children's Hospital, all identified and enrolled in the study due to their distinctive facial features. Later, four more similar cases from outside clinicians were added to the report but not enrolled.

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In each case, the babies born after their drug-affected pregnancies, particularly involving fentanyl, were initially suspected to have SLOS, or Smith-Lemli-Opitz Syndrome. This is a congenital abnormality syndrome caused by a cholesterol metabolism issue, which can lead to similar malformations as the 10 babies. 

But none of the babies were found to have SLOS or any other syndrome associated with their features — which also included abnormal thumb shape, genital irregularities and feeding issues. This prompted doctors to suspect fentanyl was causing an interference with cholesterol metabolism, leading to similar abnormalities as SLOS.

"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 in the report.

The researchers say further evidence is needed to confirm fentanyl did in fact cause the shared abnormalities, as many newborns born after any kind of substance abuse-involved pregnancy can have complications.

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