In 2023, doctors in the U.S. began noting the birth of infants with a previously unknown syndrome, characterized by multiple physical and mental defects, including fused fingers, deformed legs, and various head deformities.
It was later discovered that all the mothers of these infants had taken fentanyl (a potent opioid analgesic) during early pregnancy, and the condition was named Fetal Fentanyl Syndrome.
Fentanyl is used in medicine as a painkiller for severe illnesses, major injuries, or even euthanasia due to its extreme toxicity.
Prolonged use of fentanyl leads to severe drug addiction, with its effects on the human body similar to, but more intense than, those of heroin. This has led to a rise in fentanyl addiction in some countries, especially the U.S., in recent years. In 2021, around 70,000 people in the U.S. died from fentanyl overdoses.
The issue of deformed fentanyl babies began in the fall of 2023, when pediatricians in Delaware identified 10 infants with the described physical defects, including from California, Boston, and Rhode Island.
Since then, the number of such children has increased. Recently, Dr. Miguel Del Campo from Rady Children’s Hospital in San Diego personally examined another 20 infants with this syndrome and fears that there may be many more. It is officially unknown how many fentanyl-affected babies have been born.
It is now believed that fentanyl disrupts the fetus’s ability to produce cholesterol in the womb, directly affecting the proper development of its brain and body. Infants with this syndrome may also have a cleft palate, severely upturned noses, low-hanging eyelids, an underdeveloped lower jaw, and even webbed fingers.
“I fear that this is not rare, and I worry that these children are going unnoticed,” says Dr. Del Campo.
The birth of fentanyl-affected infants is likely directly related to the sharp increase in fentanyl overdoses in the U.S. — from 2016 to 2021, the number of overdoses tripled, reaching 21.6 cases per 100,000 people.
Fentanyl is also increasingly used to enhance the effects of other drugs, such as cocaine and ecstasy. Many drug users often do not realize they are consuming fentanyl.
Notably, just two years ago, the National Institutes of Health in the U.S. stated that “based on studies, it is not expected that fentanyl exposure would increase the likelihood of congenital defects.” However, studies have since shown that fentanyl crosses the placenta during early pregnancy and accumulates in the fetal brain tissues.
Recently, a new syndrome was studied by doctors from Vanderbilt University in Tennessee. They analyzed the similarities between the new Fetal Fentanyl Syndrome and the previously known Smith-Lemli-Opitz Syndrome (SLOS), which occurs when a person has two genes that reduce the body’s ability to produce cholesterol.
They found that when the fetus has only one of these genes, it is much more susceptible to the congenital defects associated with intrauterine fentanyl exposure.
“Fentanyl not only worsens cholesterol synthesis but also leads to the accumulation of the same highly toxic sterols found in patients with SLOS. It seems likely that the presence of this compound during fetal development plays a significant role in these syndromes,” said Ned Porter, a professor at Vanderbilt University.
In the case of thalidomide (a sedative in the 1960s that caused the birth of many thousands of infants without arms or legs), a decision to ban its use for pregnant women helped. However, with fentanyl, the situation is much more complex. Pregnant women might use the substance illegally, and not every child is affected strongly enough to cause congenital deformities. As a result, mothers may not fully understand the actual level of risk.
According to Dr. Del Campo, the number of such children is clearly increasing, and he already has in mind 2-year-old children with similar signs who, due to their congenital defects, are not growing or developing.
