Evidence map›Paper›PMID 42319656›Full record

ArticleIndian pediatrics2026

Prenatal Opioid Exposure and Subsequent Risk of Fractures in Children: An Emulated Target Trial Using a Nationwide Birth Cohort.

Hyohyeon Lee, Kyeongeun Kim, Yeona Jo, José Francisco López-Gil, Christa J Nehs, Sunyoung Kim, Jaeyu Park, Hyeon Jin Kim, Jiseung Kang, Dong Keon Yon

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Article in Indian pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hyohyeon Lee *School of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea.
Kyeongeun Kim *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
Yeona Jo *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
José Francisco López-GilSchool of Medicine, Universidad Espíritu Santo, Samborondón, Ecuador.
Christa J NehsDivision of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
Sunyoung KimDepartment of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
Jaeyu Park *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
Hyeon Jin Kim *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
Jiseung Kang *School of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea.
Dong Keon Yon *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea. yonkkang@gmail.com.ORCID http://orcid.org/0000-0003-1628-9948

Funding

Ministry of Education RS-2025-25434007Ministry of Health and Welfare RS-2025-02220492
6 · The paper itself

Abstract

objectivePrenatal opioid exposure has been linked to adverse developmental outcomes, but its effects on childhood musculoskeletal health are unclear. This study examined the association between prenatal opioid exposure and fracture risk in children.

methodsThis study emulated a target trial using a nationwide mother-child linked birth cohort from the Korean National Health Insurance Service claims data from January 1, 2009 to December 31, 2023. Prenatal opioid exposure was defined as maternal receipt of ≥ 2 opioid prescriptions during any trimester. The primary outcome was the postnatal diagnosis of any fracture, and secondary outcomes were site-specific fractures, including the head, spine, upper limb, lower limb, or other anatomical sites, as identified by relevant International Classification of Diseases 10th edition codes. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models with propensity score matching and a sibling comparison design.

resultsAfter propensity score matching, we identified 584,400 children (51.3% boys) without and 117,065 (51.3% boys) children with prenatal opioid exposure. Children with prenatal opioid exposure had an increased risk of fractures [aHR 1.07 (95% CI 1.06-1.08)], whereas no significant association was observed in the sibling comparison cohort analyses [1.02 (0.99-1.04)]. Risk of fractures showed a dose-dependent manner [low-dose exposure: 1.06 (1.05-1.08); high-dose exposure: 1.09 (1.06-1.12)].

conclusionOpioid exposure during pregnancy was not associated with a substantial increase in the risk of fractures in the children. However, exposure to high opioid doses, prolonged or frequent prenatal opioid exposure, may still warrant caution.

Indexed as

Birth cohortBone healthInjuryMaternal opioid prescriptionNewborn

Identifiers

PMID42319656

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.