The Effect of Drugs on Pregnancy

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THE EFFECTS OF COMMONLY ABUSED SUBSTANCES ON

MATERNAL, FETAL AND NEONATAL HEALTH

Victoria Hargan

MA Forensic Psychology


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Drug Abuse among Pregnant Women in the U.S.

According to the National Institute of Health (NIH)

Exposure to substances abuse can affect individualsacross the lifespan, starting in utero. While most pregnant

women do not abuse illicit drugs, combined 2008 and 2009

data from the National Survey on Drug Use and Health

found that among pregnant women ages 15 to 44, theyoungest ones generally reported the greatest substance

use (2011).

Further, pregnant women ages 15 to 17 had similar rates ofillicit drug use (15.8 percent or 14,000 women) as women

of the same age who were not pregnant (13.0 percent or

832,000 women) (NIH, 2011).


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A 2008-2009 Study


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Placental Membrane

The placenta of pregnant women acts as a

filter to the baby, and not a barrier as once

believed. Virtually all drugs pass through the

placenta and into the fetus.

The placenta mediates substances from

mother to child and vice versa.


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Caffeine

Coffee, tea, cola, chocolate, cold remedies

over the counter (otc) pills


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Caffeine

Maternal Effects

CNS and cardiac

function stimulation

Vasoconstriction andmild diuresis result

Half-life triples during

pregnancy

Fetal Effects

Placental barrier is

crossed, stimulating

fetus Teratogenic effects

are undocumented


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Cigarettes

Tobacco and Nicotine


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Nicotine

Smoking during pregnancy is associatedwith adverse effects for the fetus, newborn,

and mother.According to NIH Carbon monoxide and nicotine from

tobacco smoke may interfere with fetal oxygen supplyand because nicotine readily crosses the placenta, it can

reach concentrations in the fetus that are much higher than

maternal levels. Nicotine concentrates in fetal blood,

amniotic fluid, and breast milk, exposing both fetuses andinfants to toxiceffects (NIH, 2011).


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Tobacco

Maternal Effects

Decreased placental

perfusion

Anemia

PROM< preterm

labor, spontaneous

abortion

Fetal/Neonatal Effects

Prematurely

LBW

Fetal demise

Developmental delays

Increased incidence

of SIDS Pneumonia


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Alcohol

Alcohol (beer, wine, mixed drinks, after-

dinner drinks)


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Alcohol

Maternal Effects

Spontaneous abortion


Fetal demise

IUGR, FAS (Facial

and cranial anomaliesdevelopmental delay,

mental retardation,

short attention span),

Fetal alcohol effects(milder form of FAS

fetal alcohol

syndrome)


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Narcotics

Narcotics (heroin, methadone, morphine)


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Treating Addiction During Pregnancy

According to NIH Research shows that some medications that areeffective in drug-abusing populations can also be beneficial for

pregnant women (and their babies). For example, methadone

maintenance combined with prenatal care and a comprehensive drug

treatment program can improve many of the detrimental maternal and

neonatal outcomes associated with untreated heroin abuse, althoughnewborns exposed to methadone during pregnancy typically require

treatment for withdrawalsymptoms (NIH, 2011).

Medication buprenorphine used for opioid dependence has recently

been shown to produce fewer neonatal abstinence symptoms in babiesthan methadone, resulting in shorter infant hospital stays. (NIH, 2011).


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Narcotics

Maternal Effects Spontaneous abortion

PROM, preterm labor,

Increased incidenceof STDs

Increase HIV

exposure

Hepatitis

Malnutrition

Effects on Fetus IUGR

Perinatal asphyixia

Intellectual

impairment

Neonatal abstinence

syndrome

Neonatal infections

Neonatal death

(SIDS, child abuse

and neglect)


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Sedatives

Barbiturates, tranquilizers, anti-anxiety


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Sedatives

Maternal Effects

Lethargy

Drowsiness

CNS depression

Fetal Effects

Neonatal abstinence

syndrome

Seizures

Delayed lung maturity

Possible teratogenic

effects


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Cocaine

Cocaine and crack


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Cocaine and CrackMaternal Effects

Hyper -arousal state

Generalized vaso-constriction

Hypertension

Increased spontaneous

abortion Abruption placentae

Preterm labor

Cardiovascular complications

(stroke, heart attack)

Seizures

Increased STDs

Fetal and Neonatal Effects

Stillbirth

Premature

IUR

Irritability

Decreased ability to interactwith environmental stimuli

Poor feeding reflexes

Nausea, vomiting, diarrhea

Decreased intellectual

development

Distended, flabby, creased

abdomen (prune-belly

syndrome) resulting from

absence of abdominal muscles


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Amphetamines

Amphetamines ( Speed or ice when

processed in crystals to smoke)

Methamphetamines ( ecstasy)


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Amphetamines

Maternal Effects

Malnutrition

Tachycardia

Withdrawal symptoms

( lethargy,

depression)


Increased risk for

cardiac anomalies

Increase for cleftpalate

IUGR

Withdrawal symptoms Fetal death


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Marijuana

Marijuana (pot or grass)


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Marijuana

Maternal Effects Often used with other

drugs: alcohol,

cocaine, tobacco

Increased incidenceof anemia

Inadequate weight

gain

Fetal/Neonatal Effects Unclear, more study

needed

Believed to be related

to prematurity

IUGR

Neonatal tremors

Sensitivity to light.


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Treatment

Treating substance abuse during pregnancyshould begin as soon as the mother learns

that she is pregnant.

Women who plan of becoming pregnant

should talk to their doctors regarding pre-

pregnancy health including the use ofsubstances and addictions they may have.


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TreatmentIf a woman who uses substances such as tobacco,

nicotine, caffeine, alcohol, or drugs and becomespregnant unintentionally should immediately

contact their doctor to develop a treatment plan for

both the mother and developing

embryo/fetus/neonatal.

T


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Treatment

Treatment always includes a prenatal regimen of prenatal

vitamins and nutritional diet to support both mother andbaby.

Regular doctors visits

Regular exercise (per doctors orders)

Adequate sleep

Stress reduction

Education on pregnancy and health

If the mother is a substance abuser, an individual treatment

plan should be designed by her doctor.


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References

DRUGS IN PREGNANCY: Effects on the Fetus and Newborn

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1575893/

Murray, S.S., McKinney, E.S., Gorrie, T., M., (2002) Foundations of Maternal

Newborn Nursing (3rd Ed). St. Louis. W.B. Saunders Co.

National Institute of Health: Prenatal Exposure to Drugs of Abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abuse
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1575893/http://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abusehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1575893/

The Effect of Drugs on Pregnancy

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