{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T19:56:18Z","timestamp":1787860578831,"version":"build-2784847793"},"reference-count":48,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["175286"],"award-info":[{"award-number":["175286"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,4,17]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Opioids are prescribed to manage pain. Approximately 1 in 20 pregnant women in Canada are prescribed opioids during the prenatal period, which may occur concurrently with other psychotropic drug use. The health implications of the independent and concurrent prenatal use of these drugs are not fully understood; however, adverse neonatal and longer-term outcomes have been suggested. This protocol describes a study to update the epidemiology of prenatal exposure to opioid and other psychotropic drug use during pregnancy, providing an enhanced understanding of the potential impacts on the mother and child to help inform decisions regarding prescription and use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The retrospective cohort study design uses population-based administrative data from Manitoba and British Columbia, Canada, to investigate the effect of prenatal opioid and concurrent psychotropic drug use on maternal and child outcomes. All mother\u2013child dyads from 2000\/2001 to 2019\/2020 (approximately 1M pairs) will be identified and assigned to exposure groups based on the number of opioid and other psychotropic drug dispensations to the mother during the prenatal period. Maternal sociodemographic characteristics, prescribing patterns, short- and long-term child health and education outcomes and maternal outcomes will be examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study was approved by the University of Manitoba Human Research Ethics Board (No. HS24397 \u2013 H2020:470) and the University of British Columbia Clinical Research Ethics Board (No. H21-02262). The study will generate findings that will add to the growing body of evidence of potential short- and long-term adverse effects on children exposed to these drugs prenatally and will help to inform safe prescribing guidelines during pregnancy. Results will be published in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097657","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:01:38Z","timestamp":1746172898000},"page":"e097657","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Use of prescription opioids and other psychotropic drugs during pregnancy and their impact on the mother and developing child: protocol for a cohort study using linked administrative data from Manitoba and British Columbia, Canada"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2452-5170","authenticated-orcid":false,"given":"Deepa","family":"Singal","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marni","family":"Brownell","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Dormuth","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M","family":"Bolton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7805-7582","authenticated-orcid":false,"given":"Jennifer E","family":"Enns","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Hanlon-Dearman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence Y","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0033-6877","authenticated-orcid":false,"given":"Christine","family":"Leong","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberlyn","family":"McGrail","sequence":"additional","affiliation":[{"name":"Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan C","family":"Nickel","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Ruth","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Chateau","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health, Australian Institute of Health and Welfare, Australian National University, Canberra, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"2025121409480907000_15.5.e097657.1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170363"},{"key":"2025121409480907000_15.5.e097657.2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1055\/s-0035-1556740","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"},{"key":"2025121409480907000_15.5.e097657.3","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.211215"},{"key":"2025121409480907000_15.5.e097657.4","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/EDE.0000000000001328","article-title":"Prenatal Opioid Analgesics and the Risk of Adverse Birth Outcomes","volume":"32","author":"Brogly","year":"2021","journal-title":"Epidemiology"},{"key":"2025121409480907000_15.5.e097657.5","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.8256","article-title":"Association of Maternal Opioid Use in Pregnancy With Adverse Perinatal Outcomes in Ontario, Canada, From 2012 to 2018","volume":"3","author":"Corsi","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2025121409480907000_15.5.e097657.6","first-page":"268","article-title":"Preschool Language Development of Children Born to Women with an Opioid Use Disorder","volume":"8","author":"Kim","year":"2021","journal-title":"Children (Basel)"},{"key":"2025121409480907000_15.5.e097657.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2019.11.005"},{"key":"2025121409480907000_15.5.e097657.8","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.7326\/M19-3249","article-title":"Trends in Opioid and Psychotropic Prescription in Pregnancy in the United States From 2001 to 2015 in a Privately Insured Population\u202f: A Cross-sectional Study","volume":"173","author":"Venkatesh","year":"2020","journal-title":"Ann Intern Med"},{"key":"2025121409480907000_15.5.e097657.9","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci9090235","article-title":"Use of Prescribed Psychotropics during Pregnancy: A Systematic Review of Pregnancy, Neonatal, and Childhood Outcomes","volume":"9","author":"Creeley","year":"2019","journal-title":"Brain Sci"},{"key":"2025121409480907000_15.5.e097657.10","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000208"},{"key":"2025121409480907000_15.5.e097657.11","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1002\/pds.5312","article-title":"Prevalence of prescription opioid use during pregnancy in eight US health plans during 2001-2014","volume":"30","author":"Pocobelli","year":"2021","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2025121409480907000_15.5.e097657.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-021-04270-x","article-title":"Prevalence and duration of prescribed opioid use during pregnancy: a cohort study from the Quebec Pregnancy Cohort","volume":"21","author":"Zhao","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121409480907000_15.5.e097657.13","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20160102"},{"key":"2025121409480907000_15.5.e097657.14","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.37388","article-title":"Prevalence of Prenatal Opioid Exposure in Ontario, Canada, 2014-2019","volume":"4","author":"Camden","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025121409480907000_15.5.e097657.15","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/ppe.12721","article-title":"A population-based study of concurrent prescriptions of opioid analgesic and selective serotonin reuptake inhibitor medications during pregnancy and risk for adverse birth outcomes","volume":"35","author":"Sujan","year":"2021","journal-title":"Paediatr Perinat Epidemiol"},{"key":"2025121409480907000_15.5.e097657.16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.6405","article-title":"Prenatal Risk Factors and Perinatal and Postnatal Outcomes Associated With Maternal Opioid Exposure in an Urban, Low-Income, Multiethnic US Population","volume":"2","author":"Azuine","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025121409480907000_15.5.e097657.17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.3951"},{"key":"2025121409480907000_15.5.e097657.18","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.ajog.2010.10.004","article-title":"Methadone and perinatal outcomes: a retrospective cohort study","volume":"204","author":"Cleary","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"2025121409480907000_15.5.e097657.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2010.00176.x"},{"key":"2025121409480907000_15.5.e097657.20","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.jpain.2022.11.007","article-title":"Neonatal Outcomes Associated With in Utero Exposure to Oxycodone, Overall and by Trimester of Exposure: A Retrospective Cohort Study","volume":"24","author":"Kelty","year":"2023","journal-title":"J Pain"},{"key":"2025121409480907000_15.5.e097657.21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/ppe.12805","article-title":"Infants\u2019 prenatal exposure to opioids and the association with birth outcomes: A systematic review and meta-analysis","volume":"36","author":"Graeve","year":"2022","journal-title":"Paediatr Perinat Epidemiol"},{"key":"2025121409480907000_15.5.e097657.22","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-0514","article-title":"Cognitive and Behavioral Impact on Children Exposed to Opioids During Pregnancy","volume":"144","author":"Larson","year":"2019","journal-title":"Pediatrics"},{"key":"2025121409480907000_15.5.e097657.23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/jnu.12609","article-title":"Longitudinal Outcomes of Children Exposed to Opioids In-utero: A Systematic Review","volume":"53","author":"Arter","year":"2021","journal-title":"J Nurs Scholarsh"},{"key":"2025121409480907000_15.5.e097657.24","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-14-104"},{"key":"2025121409480907000_15.5.e097657.25","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2015.95"},{"key":"2025121409480907000_15.5.e097657.26","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0158054","article-title":"Behavior and Attention Problems in Eight-Year-Old Children with Prenatal Opiate and Poly-Substance Exposure: A Longitudinal Study","volume":"11","author":"Nygaard","year":"2016","journal-title":"PLoS ONE"},{"key":"2025121409480907000_15.5.e097657.27","doi-asserted-by":"publisher","DOI":"10.1080\/09297049.2015.1092509"},{"key":"2025121409480907000_15.5.e097657.28","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.51933","article-title":"Prenatal Opioid Exposure and Immune-Related Conditions in Children","volume":"7","author":"Kelty","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2025121409480907000_15.5.e097657.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2018.04.004"},{"key":"2025121409480907000_15.5.e097657.30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0223685","article-title":"Educational achievement at age 9.5 years of children born to mothers maintained on methadone during pregnancy","volume":"14","author":"Lee","year":"2019","journal-title":"PLoS One"},{"key":"2025121409480907000_15.5.e097657.31","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/906723","article-title":"Maternal opioid drug use during pregnancy and its impact on perinatal morbidity, mortality, and the costs of medical care in the United States","volume":"2014","author":"Whiteman","year":"2014","journal-title":"J Pregnancy"},{"key":"2025121409480907000_15.5.e097657.32","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1080\/15504263.2018.1468946","article-title":"Psychological Functioning of Women Taking Illicit Drugs during Pregnancy and the Growth and Development of Their Offspring in Early Childhood","volume":"14","author":"Serino, MA","year":"2018","journal-title":"J Dual Diagn"},{"key":"2025121409480907000_15.5.e097657.33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002974","article-title":"Long-term mortality in mothers of infants with neonatal abstinence syndrome: A population-based parallel-cohort study in England and Ontario, Canada","volume":"16","author":"Guttmann","year":"2019","journal-title":"PLoS Med"},{"key":"2025121409480907000_15.5.e097657.34","doi-asserted-by":"crossref","unstructured":"Singal D , Chateau D , Dahl M , et al . Prescription Opioid Use and Concurrent Psychotropic Drug Use During Pregnancy: A Population-Based Retrospective Cohort Study Utilizing Linked Administrative Data. IJPDS 2018;3. doi:10.23889\/ijpds.v3i4.976","DOI":"10.23889\/ijpds.v3i4.976"},{"key":"2025121409480907000_15.5.e097657.35","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/s41380-024-02697-0","article-title":"Safety of psychotropic medications in pregnancy: an umbrella review","volume":"30","author":"Fabiano","year":"2025","journal-title":"Mol Psychiatry"},{"key":"2025121409480907000_15.5.e097657.36","doi-asserted-by":"crossref","unstructured":"Huybrechts KF , Bateman BT , Desai RJ , et al . Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ 2017;j3326. doi:10.1136\/bmj.j3326","DOI":"10.1136\/bmj.j3326"},{"key":"2025121409480907000_15.5.e097657.37","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.1435","article-title":"Association of Maternal Use of Benzodiazepines and Z-Hypnotics During Pregnancy With Motor and Communication Skills and Attention-Deficit\/Hyperactivity Disorder Symptoms in Preschoolers","volume":"2","author":"Lupattelli","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025121409480907000_15.5.e097657.38","unstructured":"Statistics Canada . Population and dwelling counts: canada, provinces and territories."},{"key":"2025121409480907000_15.5.e097657.39","unstructured":"Fierlbeck K . Health care in Canada: a citizen\u2019s guide to policy and politics. University of Toronto Press, 2000."},{"key":"2025121409480907000_15.5.e097657.40","first-page":"2","article-title":"Population Data Centre Profile: The Manitoba Centre for Health Policy","volume":"4","author":"Katz","year":"2019","journal-title":"Int J Popul Data Sci"},{"key":"2025121409480907000_15.5.e097657.41","unstructured":"Manitoba Centre for Health Policy . Manitoba population research data repository. 2018. Available: http:\/\/umanitoba.ca\/faculties\/health_sciences\/medicine\/units\/chs\/departmental_units\/mchp\/resources\/repository\/resources_and_tools.html [Accessed 20 Sep 2022]."},{"key":"2025121409480907000_15.5.e097657.42","first-page":"2","article-title":"Supporting population data science in British Columbia","volume":"4","author":"Ark","year":"2019","journal-title":"Int J Popul Data Sci"},{"key":"2025121409480907000_15.5.e097657.43","unstructured":"Institute SAS . SAS version 15.1."},{"key":"2025121409480907000_15.5.e097657.44","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-197704000-00010"},{"key":"2025121409480907000_15.5.e097657.45","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20180027"},{"key":"2025121409480907000_15.5.e097657.46","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000581"},{"key":"2025121409480907000_15.5.e097657.47","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1093\/aje\/kwy062","article-title":"Mortality Among Mothers Whose Children Were Taken Into Care by Child Protection Services: A Discordant Sibling Analysis","volume":"187","author":"Wall-Wieler","year":"2018","journal-title":"Am J Epidemiol"},{"key":"2025121409480907000_15.5.e097657.48","first-page":"e134","article-title":"CNODES: the Canadian Network for Observational Drug Effect Studies","volume":"6","author":"Suissa","year":"2012","journal-title":"Open Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-097657","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:48:24Z","timestamp":1765734504000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-097657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":48,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,2]]},"published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1136\/bmjopen-2024-097657"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-097657","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}