Fentanyl is a synthetic opioid indicated for the treatment of cancer pain, among others, whose inappropriate use has triggered a true epidemic of opioid addiction in the United States. As an analgesic, this drug is around 100 times more powerful than morphine and 50 times more powerful than heroin, according to data from the DEA (Drug Enforcement Administration).
A new study has now revealed that the consumption of this substance can also have serious consequences for children, since it has found that babies whose mothers used fentanyl during pregnancy presented similar facial and musculoskeletal abnormalities that suggest the emergence of a new syndrome. The findings have been published in the journal Genetics in Medicine Open.
Babies with small heads and distinctive facial features
In the summer of 2022, a genetic counselor and a group of doctors at Nemours Children’s Hospital, Delaware, realized that several babies who had arrived at this medical center after being referred by local neonatal intensive care units or due to Those who showed feeding difficulties shortly after birth had similar facial features and numerous physical abnormalities, said Dr. Karen W. Gripp, Chief of the Division of Medical Genetics at Nemours Childrens Health in Wilmington and lead author of the work.
All of the babies had small heads, and many had cleft palates, deformed feet, and malformed genitals.
Gripp and his colleagues enrolled six Nemours patients in a study to closely analyze their symptoms and characteristics, and later included four other babies from other institutions. Gripp said all the babies had small heads, were short in stature and had distinctive facial features. Many of the children had cleft palates, congenital convex pes valgus, and malformed genital organs. Other common features included short, wide thumbs, a single palmar crease, and fused fingers.
Genetic testing ruled out certain suspected diagnoses, such as Smith-Lemli-Opitz syndrome, a rare genetic condition. Analysis of facial features using the GestaltMatcher algorithm (FDNA Inc.) suggested that the patients did not have fetal alcohol syndrome. By ruling out these two syndromes and confirming that all mothers had used fentanyl during pregnancy, researchers began to suspect a novel syndrome, Gripp said.
It has been shown that fentanyl can cross the placenta and cause birth defects. Gripp said that although all the mothers of the babies in the study acknowledged using fentanyl during pregnancy, information on when they had used the drug and in what quantities was limited, so he cautioned that more research will be needed to determine whether the Fentanyl caused the abnormalities, or if the symptoms developed due to a contaminant or another drug used at the same time.
Although the initial report focuses on 10 babies, Gripp says she and her colleagues have heard of more children with similar characteristics born to mothers who used fentanyl. Doctors have also reported seeing patients with similar but less severe features, suggesting that there may be a range of this new syndrome.
Of the 10 patients in the study, six continue to receive care through the Nemours system and are undergoing ongoing evaluation of their symptoms. Three are being followed by doctors in other states, and one patient has died. With the epidemic of fentanyl use, it is important to recognize this condition, Gripp said, because, like prenatal alcohol exposure that causes fetal alcohol syndrome with long-term physical and developmental consequences, this novel condition can affect the quality of life of many babies.
