Substance abuse during pregnancy

1. Substance
Abuse During
Pregnancy: The
Littlest Victims
By Jessica Gutierrez
Summer 2014
Tech Apps in Health Sciences as taught by Dr. Morris

2. World Health Organization: the harmful or
hazardous use of psychoactive substances,
including alcohol and illicit drugs
Merriam-Webster: excessive use of a drug (such as
alcohol, narcotics or cocaine)
MedicineNet: the excessive use of a substance,
especially alcohol or drug

4. Health begins in the womb
Prenatal nutrition is essential to the neonate. The placental provides nourishment to
the baby while in the womb.
Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the
same route taken by oxygen and nutrients, which are needed for the fetus's growth and
development. Drugs that a pregnant woman takes during pregnancy can affect the fetus
in several ways:
They can act directly on the fetus, causing damage, abnormal development (leading to
birth defects), or death.
They can alter the function of the placenta, usually by causing blood vessels to narrow
(constrict) and thus reducing the supply of oxygen and nutrients to the fetus from the
mother. Sometimes the result is a baby that is underweight and underdeveloped.
They can cause the muscles of the uterus to contract forcefully, indirectly injuring the
fetus by reducing its blood supply or triggering preterm labor and delivery.
They can also affect the fetus indirectly. For example, drugs that lower the mother's
blood pressure may reduce blood flow to the placenta and thus reduce the supply of
oxygen and nutrients to the fetus.
Merck, 2015

5. Drug abuse during pregnancy is
a very real problem
– The latest statistics state that as much as 5% of pregnant women
abuse drugs and/or alcohol during their pregnancy.
– The number of babies born to drug-addicted mothers has more
than doubled in the last decade.

6. Prescription drugs are a big part
of the problem
Taking prescription drugs
improperly or to excess is no
safer than taking illegal street
drugs such as heroin or cocaine.

7. •Babies born addicted to drugs (including prescription drugs) have a constant, high-pitched cry,
experience light and sound sensitivity, and suffer from a low threshold for agitation.
•Other symptoms include rashes, vomiting, and diarrhea.
•These same babies are prone to experiencing seizures.
•Addicted newborns can require elongated hospital stays can be weeks or even months longer than
babies not suffering from addiction.

8. Dependency in the newborn
– Regular drug use can produce dependence in the newborn, and the baby may
go through withdrawal upon birth. Most research in this area has focused on
the effects of opioid misuse which includes prescription pain relievers or heroin.
– Updated data has shown that use of alcohol, barbiturates, benzodiazepines, and
caffeine during pregnancy may also cause the infant to show withdrawal
symptoms at birth(Hudak et al., 2012). T

9. Neonatal Abstinence Syndrome
– Infants born to substance abusing mothers, whether prescription or illegal drug,
are at risk for neonatal abstinence syndrome (NAS). With NAS, the infant
undergoes withdrawal from the drug the mother has been using. Opioid
medications, such as Oxycodone, Vicodin, and Percocet, trigger some of the
most difficult withdrawal symptoms.
– A recent study explains that as many as 90% of babies born to mothers addicted
to opioids will go through withdrawal.

10. 1`
“Nationally, the rate of neonatal abstinence syndrome
involving mothers' use of opiates - which includes
heroin as well as prescription narcotics like codeine
and Vicodin - surged from 2.8 cases for every 1,000
births in 2009 to 7.3 cases for every 1,000 births in
2013, the study found.”
Fox News Health, 2016

11. Substance abuse in pregnancy
has real consequences:
– Research proves that abuse of tobacco, alcohol, or illicit
drugs or abuse of prescription drugs by pregnant women can
have severe health consequences for infants. This is due to
the fact that substances pass easily through the placenta, so
substances that a pregnant woman takes also reach the
baby (Neonatal abstinence syndrome, 2014).

12. Stillbirth due to substance abuse
– Recent research shows that smoking tobacco or marijuana, taking prescription
pain relievers, or using illegal drugs during pregnancy is associated with double
or even triple the risk of stillbirth (Tobacco, drug use in pregnancy, 2013).
– Risks of Stillbirth from Substance Use in Pregnancy
– Tobacco use—1.8 to 2.8 times greater risk of stillbirth, with the highest risk found among the
heaviest smokers
– Marijuana use—2.3 times greater risk of stillbirth
– Evidence of any stimulant, marijuana, or prescription pain reliever use—2.2 times greater risk of
stillbirth
– Passive exposure to tobacco—2.1 times greater risk of stillbirth
– (Source: Tobacco, drug use in pregnancy, 2013)

13. Withdrawal may be temporary
but there are lifelong issues
– Too much alcohol while pregnant may lead to fetal alcohol syndrome. Small
amounts of alcohol may have an effect on brain development. Smoking
during pregnancy can slow fetal growth and brain development as well.
– Consumption of dangerous drugs is not safe for the unborn baby. Studies have
shown that consumption of illegal drugs or improperly used prescription drugs
can result in miscarriage, low birth weight, premature labor, placental abruption
and even fetal death.
– Later in life these infants may experience learning disabilities and are far more
likely to struggle with addictions than their peers not born to drug-addicted
mothers.

14. Treatment for drug addicted mothers is
essential
Drug addiction requires professional intervention. Drug and alcohol abuse
change the way a person thinks so it is nearly impossible for a pregnant
woman to change her addiction without help –no matter how much she loves
her baby.

15. REFERENCES
Centers for Disease Control and Prevention (CDC). The Health Consequences of Smoking—50 Years of
Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health
Promotion, Office on Smoking and Health, 2014.
Hudak ML, Tan RC, The Committee on Drugs, The Committee on Fetus and Newborn. Clinical report:
neonatal drug withdrawal. Pediatrics. 2012;129(2):e540-e560.
Medications and Breastfeeding. HealthyChildren.org. American Academy of
Pediatrics. www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Medications-and-
Breastfeeding.aspx
Medications and Pregnancy. Centers for Disease Control and
Prevention. www.cdc.gov/pregnancy/meds/index.html.
Tobacco Use and Pregnancy. Centers for Disease Control and
Prevention. www.cdc.gov/Reproductivehealth/TobaccoUsePregnancy/index.htm.