This article from AIMS (Association for Improvement of Maternity Services) might be of interest to some of you - it refers to reserach on the effect of epidurals, pethidine and diamorphine:
Another study has confirmed the Swedish research which showed a relationship between women receiving pain relieving drugs in labour and their children having a greater risk of becoming drug addicts in later life.
In Rhode Island, USA, researchers have been following up over 4,000 children born from 1959-66. A previous study of psychiatric problems in these children had identified 69 who developed drug addiction problems. Using the same technique as had already been used in Stockholm, they compared their birth care with that of 33 of their brothers and sisters who were also in the long-term study. Using siblings as controls means that they would have similar background and social circumstances.
They found that 23% of addicts and only 6% of controls had been exposed to three or more doses of opiates or barbiturates given to the mother within 10 hours of their birth. This means a four to fivefold increase in addiction risk. The researchers checked to see whether other obstetric factors could account for the difference, and they did not.
They conclude, "These findings imply that in utero exposure to high dose medication may be an important and preventable risk factor for later substance abuse."
AIMS Comment
Ever since the Swedish research was first published in 1988 we have been badgering governments and Royal Colleges to consider the serious implications, and suggesting at the very least repeat studies should be done. Only this summer, after writing to Tony Blair. we got a response from the Department of Health saying the Swedish work was on a small sample, it was now over a decade old, other researchers had not taken it up and they would need more convincing evidence before they did further research in the UK.
Now a study on a different population shows similar results. The first author, Karin Nyberg, was one of the original Swedish team, now at Gothenberg University. The other two come from Harvard Medical School of Public Health and Brown University Department of Psychology. The work was funded by the Swedish Medical Association and the National Institute of Mental Health in the USA. This can hardly be dismissed as maverick. backwoods stuff. However, research which produces awkward findings is, as Michel Odent has pointed out, seldom replicated or quoted.
This study has the advantage that it is based on data collected prospectively, so birth records are good. However, the sample is still small, for understandable reasons, and the addiction figures are for barbiturates (no longer used) as well as opiates. It is unfortunate that there are so few controls.
It only tells us about children of mothers who had three or more doses. We do not know what effects, if any, smaller or less frequent doses could have. This is an area where animal research might help, and the authors do quote one study on rats which gives some support to the idea that drugs given early may alter the reaction of the brain to exposure in later life.
Anyway, we continue our weary battle with the Department of Health.
Reference
Nyberg, K, et al, Perintal medication as a potential risk factor for adult drug abuse in a North American cohort, Epidemiology, 2000: 11: 715-6