{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:20:35Z","timestamp":1790634035007,"version":"4.1.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"DOI":"10.1001\/jamanetworkopen.2021.5708","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T02:38:57Z","timestamp":1618367937000},"page":"e215708","source":"Crossref","is-referenced-by-count":21,"title":["Association of Gestational Opioid Exposure and Risk of Major and Minor Congenital Malformations"],"prefix":"10.1001","volume":"4","author":[{"given":"Xuerong","family":"Wen","sequence":"first","affiliation":[{"name":"Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Belviso","sequence":"additional","affiliation":[{"name":"Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Murray","sequence":"additional","affiliation":[{"name":"Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam K.","family":"Lewkowitz","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina E.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimford J.","family":"Meador","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"issue":"1","key":"zoi210188r1","first-page":"25","article-title":"Treating pain during pregnancy.","volume":"56","author":"Babb","year":"2010","journal-title":"Can Fam Physician"},{"key":"zoi210188r2","article-title":"Pain management in pregnancy: multimodal approaches.","volume":"2015","author":"Shah","year":"2015","journal-title":"Pain Res Treat"},{"key":"zoi210188r4","author":"Babb","year":"2010"},{"issue":"2","key":"zoi210188r5","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1055\/s-00029027","article-title":"Prescription opioids in pregnancy and birth outcomes: a review of the literature.","volume":"4","author":"Yazdy","year":"2015","journal-title":"J Pediatr Genet"},{"issue":"n102","key":"zoi210188r6","doi-asserted-by":"publisher","first-page":"n102","DOI":"10.1136\/bmj.n102","article-title":"Association of first trimester prescription opioid use with congenital malformations in the offspring: population based cohort study.","volume":"372","author":"Bateman","year":"2021","journal-title":"BMJ"},{"issue":"7","key":"zoi210188r7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0219061","article-title":"Pregnancy outcome following opioid exposure: a cohort study.","volume":"14","author":"Fishman","year":"2019","journal-title":"PLoS One"},{"issue":"4","key":"zoi210188r8","doi-asserted-by":"publisher","first-page":"314.e1","DOI":"10.1016\/j.ajog.2010.12.039","article-title":"Maternal treatment with opioid analgesics and risk for birth defects.","volume":"204","author":"Broussard","year":"2011","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"zoi210188r9","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1097\/AOG.0b013e3182a6643c","article-title":"Periconceptional use of opioids and the risk of neural tube defects.","volume":"122","author":"Yazdy","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"5","key":"zoi210188r10","doi-asserted-by":"publisher","first-page":"407","DOI":"10.5055\/jom.2019.0529","article-title":"Birth outcomes with prescribed chronic and acute opioid exposure during pregnancy.","volume":"15","author":"Delate","year":"2019","journal-title":"J Opioid Manag"},{"issue":"6","key":"zoi210188r11","first-page":"35","article-title":"Prescription opioid use among pregnant women enrolled in Rhode Island Medicaid.","volume":"102","author":"Wen","year":"2019","journal-title":"R I Med J (2013)"},{"issue":"11","key":"zoi210188r12","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1002\/bdra.v97.11","article-title":"Selected birth defects data from population-based birth defects surveillance programs in the United States, 2006 to 2010: featuring trisomy conditions.","volume":"97","author":"Mai","year":"2013","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"issue":"6","key":"zoi210188r17","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1002\/(ISSN)1099-1557","article-title":"Birth defect classification by organ system: a novel approach to heighten teratogenic signalling in a pregnancy registry.","volume":"11","author":"Scheuerle","year":"2002","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"6","key":"zoi210188r18","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1515\/JPM.2007.132","article-title":"The relationship between congenital malformations and preterm birth.","volume":"35","author":"Kase","year":"2007","journal-title":"J Perinat Med"},{"issue":"3","key":"zoi210188r19","first-page":"296","article-title":"Evaluation of the hospital discharge diagnoses index and the birth certificate as sources of information on birth defects.","volume":"105","author":"Hexter","year":"1990","journal-title":"Public Health Rep"},{"issue":"10","key":"zoi210188r21","doi-asserted-by":"publisher","first-page":"665","DOI":"10.7326\/M18-0338","article-title":"\u00df-Blocker use in pregnancy and the risk for congenital malformations: an international cohort study.","volume":"169","author":"Bateman","year":"2018","journal-title":"Ann Intern Med"},{"issue":"9","key":"zoi210188r22","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1001\/jamapsychiatry.2016.1520","article-title":"Antipsychotic use in pregnancy and the risk for congenital malformations.","volume":"73","author":"Huybrechts","year":"2016","journal-title":"JAMA Psychiatry"},{"issue":"23","key":"zoi210188r23","doi-asserted-by":"publisher","first-page":"2443","DOI":"10.1056\/NEJMoa055202","article-title":"Major congenital malformations after first-trimester exposure to ACE inhibitors.","volume":"354","author":"Cooper","year":"2006","journal-title":"N Engl J Med"},{"issue":"5","key":"zoi210188r24","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1002\/(ISSN)1099-1557","article-title":"Positive predictive value of computerized records for major congenital malformations.","volume":"17","author":"Cooper","year":"2008","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"6","key":"zoi210188r25","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1002\/pds.v23.6","article-title":"Validity of maternal and infant outcomes within nationwide Medicaid data.","volume":"23","author":"Palmsten","year":"2014","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"1","key":"zoi210188r26","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1097\/01.AOG.0000129403.54061.0e","article-title":"Low back pain during pregnancy: prevalence, risk factors, and outcomes.","volume":"104","author":"Wang","year":"2004","journal-title":"Obstet Gynecol"},{"issue":"8","key":"zoi210188r27","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1097\/01.brs.0000158957.42198.8e","article-title":"Low back pain and pelvic pain during pregnancy: prevalence and risk factors.","volume":"30","author":"Mogren","year":"2005","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"zoi210188r28","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/EDE.0000000000000595","article-title":"A Propensity-score\u2013based fine stratification approach for confounding adjustment when exposure is infrequent.","volume":"28","author":"Desai","year":"2017","journal-title":"Epidemiology"},{"key":"zoi210188r29","doi-asserted-by":"publisher","first-page":"l5657","DOI":"10.1136\/bmj.l5657","article-title":"Alternative approaches for confounding adjustment in observational studies using weighting based on the propensity score: a primer for practitioners.","volume":"367","author":"Desai","year":"2019","journal-title":"BMJ"},{"issue":"1","key":"zoi210188r31","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.pedneo.2014.03.010","article-title":"Congenital malformations in the newborn population: a population study and analysis of the effect of sex and prematurity.","volume":"56","author":"Egbe","year":"2015","journal-title":"Pediatr Neonatol"},{"issue":"4","key":"zoi210188r32","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/S0022-3476(87)80543-7","article-title":"Predictive value of minor anomalies: I\u2014association with major malformations.","volume":"110","author":"Leppig","year":"1987","journal-title":"J Pediatr"},{"issue":"3","key":"zoi210188r33","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s00404-001-0265-4","article-title":"Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990-1998).","volume":"266","author":"Queisser-Luft","year":"2002","journal-title":"Arch Gynecol Obstet"},{"issue":"2","key":"zoi210188r35","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/0028-2243(92)90055-4","article-title":"Prevalence of minor congenital anomalies in newborns of diabetic mothers.","volume":"44","author":"Hod","year":"1992","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"6","key":"zoi210188r36","first-page":"272","article-title":"Prevalence of minor musculoskeletal anomalies in children with congenital hypothyroidism.","volume":"68","author":"El Kholy","year":"2007","journal-title":"Horm Res"},{"issue":"2","key":"zoi210188r37","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1017\/S0012162200000177","article-title":"Psychomotor development and minor anomalies in children exposed to antiepileptic drugs in utero: a prospective population-based study.","volume":"42","author":"Wide","year":"2000","journal-title":"Dev Med Child Neurol"},{"issue":"4","key":"zoi210188r38","doi-asserted-by":"publisher","first-page":"e99","DOI":"10.1542\/neo.4-4-e99","article-title":"The importance of minor anomalies in the evaluation of the newborn.","volume":"4","author":"Adam","year":"2003","journal-title":"NeoReviews"},{"issue":"6","key":"zoi210188r39","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1111\/j.1651-2227.2004.tb03027.x","article-title":"Prevalence and significance of minor anomalies in children with impaired development.","volume":"93","author":"Ulovec","year":"2004","journal-title":"Acta Paediatr"},{"issue":"3","key":"zoi210188r40","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1093\/schbul\/19.3.551","article-title":"Minor physical anomalies in schizophrenia and mood disorders.","volume":"19","author":"Lohr","year":"1993","journal-title":"Schizophr Bull"},{"issue":"1","key":"zoi210188r41","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1093\/schbul\/15.1.91","article-title":"Minor physical anomalies in schizophrenia.","volume":"15","author":"Green","year":"1989","journal-title":"Schizophr Bull"},{"issue":"2","key":"zoi210188r44","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1053\/j.ro.2003.12.003","article-title":"Congenital abnormalities of the musculoskeletal system: perinatal evaluation and long-term outcome.","volume":"39","author":"Fordham","year":"2004","journal-title":"Semin Roentgenol"},{"issue":"5","key":"zoi210188r46","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/00004703-200510000-00008","article-title":"Neurodevelopmental implications of \u201cdeformational\u201d plagiocephaly.","volume":"26","author":"Collett","year":"2005","journal-title":"J Dev Behav Pediatr"},{"issue":"1","key":"zoi210188r47","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1097\/01.prs.0000185604.15606.e5","article-title":"Neurodevelopmental delays in children with deformational plagiocephaly.","volume":"117","author":"Kordestani","year":"2006","journal-title":"Plast Reconstr Surg"},{"issue":"7","key":"zoi210188r48","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1001\/archpediatrics.2011.92","article-title":"Development in toddlers with and without deformational plagiocephaly.","volume":"165","author":"Collett","year":"2011","journal-title":"Arch Pediatr Adolesc Med"},{"key":"zoi210188r49","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.jpeds.2017.12.009","article-title":"Torticollis in infants with a history of neonatal abstinence syndrome.","volume":"196","author":"McAllister","year":"2018","journal-title":"J Pediatr"},{"issue":"6","key":"zoi210188r50","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-4131","article-title":"Maternal use of opioids during pregnancy and congenital malformations: a systematic review.","volume":"139","author":"Lind","year":"2017","journal-title":"Pediatrics"},{"issue":"3","key":"zoi210188r51","first-page":"336","article-title":"Exposure to prescribed drugs in pregnancy and association with congenital malformations.","volume":"58","author":"Bracken","year":"1981","journal-title":"Obstet Gynecol"},{"key":"zoi210188r52","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1016\/j.reprotox.2015.10.007","article-title":"Use of tramadol in early pregnancy and congenital malformation risk.","volume":"58","author":"K\u00e4ll\u00e9n","year":"2015","journal-title":"Reprod Toxicol"},{"issue":"10","key":"zoi210188r53","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.3390\/ph6101221","article-title":"The use of central nervous system active drugs during pregnancy.","volume":"6","author":"K\u00e4ll\u00e9n","year":"2013","journal-title":"Pharmaceuticals (Basel)"},{"issue":"17","key":"zoi210188r54","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1056\/NEJM198604243141716","article-title":"Drug use in pregnancy and congenital heart disease in offspring.","volume":"314","author":"Bracken","year":"1986","journal-title":"N Engl J Med"},{"issue":"4","key":"zoi210188r55","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1093\/oxfordjournals.aje.a112701","article-title":"Exogenous hormones and other drug exposures of children with congenital heart disease.","volume":"109","author":"Rothman","year":"1979","journal-title":"Am J Epidemiol"},{"issue":"6","key":"zoi210188r56","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1056\/NEJM198508083130603","article-title":"Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy.","volume":"313","author":"Zierler","year":"1985","journal-title":"N Engl J Med"},{"issue":"2","key":"zoi210188r57","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/S0006-8993(99)01753-9","article-title":"Opioid growth factor and organ development in rat and human embryos.","volume":"839","author":"Zagon","year":"1999","journal-title":"Brain Res"},{"issue":"3","key":"zoi210188r58","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/S0165-0173(01)00160-6","article-title":"The biology of the opioid growth factor receptor (OGFr).","volume":"38","author":"Zagon","year":"2002","journal-title":"Brain Res Brain Res Rev"},{"issue":"1","key":"zoi210188r59","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/s12031-009-9312-6","article-title":"Maternal oral consumption of morphine increases Bax\/Bcl-2 ratio and caspase 3 activity during early neural system development in rat embryos.","volume":"41","author":"Nasiraei-Moghadam","year":"2010","journal-title":"J Mol Neurosci"},{"issue":"3","key":"zoi210188r60","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/0272-0590(91)90081-E","article-title":"Codeine: developmental toxicity in hamsters and mice.","volume":"16","author":"Williams","year":"1991","journal-title":"Fundam Appl Toxicol"},{"issue":"4","key":"zoi210188r61","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.2105\/AJPH.2013.301823","article-title":"Prescription medication sharing: a systematic review of the literature.","volume":"104","author":"Beyene","year":"2014","journal-title":"Am J Public Health"},{"key":"zoi210188r34","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780195165685.001.0001","volume-title":"Human Malformations and Related Anomalies.","author":"Stevenson","year":"2005"},{"key":"zoi210188r42","volume-title":"Basic Concepts in Teratology","author":"Persaud","year":"1985"},{"key":"zoi210188r43","author":"Daldrup-Link","year":"2008"},{"key":"zoi210188r3","unstructured":"ACOG. Opioid use and opioid use disorder in pregnancy. Published August 2017. Accessed September 3, 2020. https:\/\/www.acog.org\/en\/Clinical\/Clinical%20Guidance\/Committee%20Opinion\/Articles\/2017\/08\/Opioid%20Use%20and%20Opioid%20Use%20Disorder%20in%20Pregnancy?"},{"key":"zoi210188r13","unstructured":"Rhode Island Department of State. Rhode Island Birth Defects Registry (216-RICR-10-10-3). Accessed January 17, 2021. https:\/\/rules.sos.ri.gov\/regulations\/part\/216-10-10-3"},{"key":"zoi210188r14","unstructured":"New York State Department of Health. ICD-10 coding manual. List of all reportable congenital malformations. Updated October 22, 2019. Accessed April 23, 2020. https:\/\/www.health.ny.gov\/diseases\/congenital_malformations\/docs\/icd.pdf"},{"key":"zoi210188r15","unstructured":"ICD-10 Version:2010. Accessed April 23, 2020. https:\/\/icd.who.int\/browse10\/2010\/en"},{"key":"zoi210188r16","unstructured":"NBDPN guidelines for conducting birth defects surveillance. Chapter 5: classification and coding. Accessed April 22, 2020. https:\/\/www.nbdpn.org\/docs\/Ch_5_Classification_Coding6-04_no_app_2016DEC14.pdf"},{"key":"zoi210188r20","unstructured":"Centers for Disease Control and Prevention. 5.2 International Classification of Diseases. Published December 29, 2015. Accessed April 23, 2020. https:\/\/www.cdc.gov\/ncbddd\/birthdefects\/surveillancemanual\/chapters\/chapter-5\/chapter5-2.html"},{"key":"zoi210188r30","unstructured":"Opioid oral morphine milligram equivalent (MME) conversion factors. Accessed July 2, 2020. https:\/\/www.cms.gov\/Medicare\/Prescription-Drug-Coverage\/PrescriptionDrugCovContra\/Downloads\/Oral-MME-CFs-vFeb-2018.pdf"},{"key":"zoi210188r45","unstructured":"ScienceDirect Topics. Musculoskeletal system malformation\u2014an overview. Accessed July 3, 2020. https:\/\/www.sciencedirect.com\/topics\/pharmacology-toxicology-and-pharmaceutical-science\/musculoskeletal-system-malformation"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2778519\/wen_2021_oi_210188_1617734259.43434.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T07:55:45Z","timestamp":1724831745000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2778519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,13]]},"references-count":61,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.5708","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,13]]}}}