Infants born to heroin addicts have a lower incidence of which condition?

• A. Hyperbilirubinemia
• B. Polycythemia
• C. Thrombocytopenia
• D. Intrauterine growth restriction

Answer: (A)

Infants exposed to opioids in utero often develop neonatal abstinence syndrome, and they can face growth restriction and certain hematologic or metabolic issues. The pattern for bilirubin specifically is that hyperbilirubinemia is not a prominent or consistently increased problem in these babies, and in some observations its incidence is lower compared with other drug-exposed or high-risk neonatal groups. This is because hyperbilirubinemia typically arises from factors like excessive RBC turnover (as seen with polycythemia), prematurity, or hepatic immaturity leading to slower bilirubin conjugation; opioid exposure itself does not reliably drive those processes in the same way, so bilirubin levels do not routinely rise as a major concern.

In contrast, other listed conditions are more plausibly linked to heroin exposure: intrauterine growth restriction is a known risk with opioid use, and there can be hematologic or coagulation-related effects (including thrombocytopenia) in substance-exposed newborns, while polycythemia can occur in the setting of fetal hypoxia. Therefore, among the options, hyperbilirubinemia is the best choice for a condition with a comparatively lower incidence in infants born to heroin-addicted mothers.