Dozens more babies have been born in the United States with a terrifying new disease linked to fentanyl abuse during pregnancy.
The condition, known as fetal fentanyl syndrome, causes multiple physical and brain defects, including fused fingers, toes and deformed heads.
Dr. Miguel Del Campo of Rady Children’s Hospital in San Diego has seen 20 babies with the condition and fears the problem is much more widespread and going undetected.
The syndrome was only identified last fall, and there is no national or state data to track its prevalence.
In addition to having underdeveloped jaws, some of the babies also had cleft palates.
Dr. Del Campo was inspired by that research, which was published by doctors at Vanderbilt University, the University of Nebraska Medical Center and Nemours Children’s Hospital in Delaware.
He said: “After reading the article and thinking about things, I recognized the potential for fentanyl exposure.”
Fentanyl is thought to damage a baby’s ability to produce cholesterol in the womb, which is crucial for brain development.
Babies with this syndrome often have cleft palates, “rocker feet” (so called because the bent feet resemble the legs of a rocking chair), turned-up noses, drooping eyelids, small lower jaws, and webbed toes.
Dr. Del Campo said NBC News:’I have identified 20 patients’ with these characteristics.
“I fear that this is not rare and I fear that there are children who are going undetected,” added Dr. Del Campo.
Fears are growing that the number of cases is an undercount as fentanyl has emerged as the leading cause of overdose deaths. Rates of fatal overdoses involving fentanyl are at an all-time high, tripling between 2016 and 2021, from 5.7 per 100,000 people in 2016 to 21.6 in 2021.
Fentanyl is increasingly being used to adulterate other substances and hook users, who often do not know they are consuming fentanyl.
Babies found to be affected by maternal fentanyl use had smaller heads and underdeveloped jaws overall.
More evidence is needed to prove beyond a doubt that fentanyl is the cause of these birth defects, which is not yet an established scientific fact.
The National Institutes of Health, for example, said just two years ago that “based on the studies reviewed, exposure to fentanyl is not expected to increase the risk of birth defects above background risk.”
Fentanyl passes through the placentathe organ that develops during pregnancy and provides oxygen and nutrients to the fetus.
The researchers identified a previous study that had found “fentanyl in fetal brain tissue, concluding that there is rapid transfer of fentanyl to the fetus early in pregnancy and that the drug remains in fetal tissue for some time.”
But the NIH has said that “studies have not found a specific pattern of birth defects caused by opioids” and cannot conclude that fentanyl causes these effects.
Some of the babies also had wider thumbs than normally seen, as well as a single horizontal crease in their palms instead of the normal two.
Several babies had fused toes and rounded, “rocking chair” feet.
Last year, Delaware pediatricians and their researchers identified 10 babies with defects in their state, as well as in California, Boston and Rhode Island, who are believed to be suffering from fetal fentanyl syndrome. The study was independent of the one conducted by the Vanderbilt scientists.
A link between cholesterol production and these symptoms had not been established until Vanderbilt scientists began investigating possible causes.
They analyzed the similarities between fetal fentanyl syndrome and a genetic disorder called Smith-Lemli-Opitz syndrome (SLOS), caused when a person has two genes that affect the body’s ability to make cholesterol.
They found that when a fetus has only one of those genes, it is much more susceptible to these birth defects related to fentanyl exposure in the womb.
Ned Porter, a research professor of chemistry at Vanderbilt, said: ‘Fentanyl not only impairs cholesterol synthesis, but also leads to the accumulation of the same highly toxic sterols in cells found in SLOS patients.
‘It seems likely that the presence of this compound during fetal development plays an important role in these syndromes.’