Morgridge Institute for Research: Wisconsin bioethics project chronicles pregnancy, substance use disorder and the law

Morgridge Institute for Research: Wisconsin bioethics project chronicles pregnancy, substance use disorder and the law

The National Institutes of Health (NIH) is embarking on a massive research project to shed light on early child development, including the health and developmental implications of opioid use during pregnancy.  The very first task is to ensure the study — the HEALthy Brain and Child Development study (HBCD) — is on solid legal and ethical ground.

A team of Wisconsin law and bioethics scholars are supporting HBCD with a 50-state analysis of the surprisingly diverse range of laws that address substance use during pregnancy — ranging from court-ordered treatment, to loss of child custody, to possible imprisonment.

PIlar Ossorio

Pilar Ossorio, professor of law and bioethics at the University of Wisconsin-Madison and bioethicist-in-residence at the Morgridge Institute for Research, says the 50-state analysis is critical to protecting both research participants and researchers so this important work can move forward. Biomedical science does not have a firm grasp on all of the downstream child health impacts of substance use during pregnancy, Ossorio says, an issue made more pressing by the widespread opioid epidemic.

The Department of Health and Human Services estimated that 1.6 million U.S. citizens had an opioid use disorder in 2019. More than 48,000 deaths between June 2019 and June 2020 were attributed to opioid overdoses. In a Centers for Disease Control study, about 7 percent of women in 2019 self-reported using prescription opioid pain relievers during pregnancy,  and polysubstance use during pregnancy is increasingly common.

The HBCD study will recruit around 10,000 pregnant women, follow them through their pregnancies, and study their children through age 10. Some portion of the pregnant participants will have reported using substances (particularly opioids) at some point during their pregnancy. One goal of the HBCD will be to identify the impacts of such exposures on child development and to suggest strategies to improve health and potentially save lives.

“There is clearly a huge demand in the medical and research community for more knowledge and help in this area,” Ossorio says. “NIH has completed a very successful study looking at adolescent brain cognitive development from ages 9-10. But obviously a lot of brain, cognitive, behavioral and emotional development happens before that time.”