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Drug Use During Pregnancy

Substance abuse doesn’t just negatively impact the life of the person using the drug. Especially when a woman engages in drug use during pregnancy.

The effects of drugs and alcohol during pregnancy are well-documented. If you abuse drugs while pregnant, you risk having a premature birth and/or a baby with serious birth defects. Drug abuse puts the baby at risk of being born with an addiction and can result in lifelong challenges for the infant.

Important Facts About Substance Abuse During Pregnancy

According to the 2013 U.S. National Survey on Drug Use and Health, 5.4% of all pregnant women reported drug use, and 9.4% reported alcohol consumption. In surveys, 20% of women reported some alcohol consumption during pregnancy. However, these rates have decreased in the past 15 years. This is partially due to increased awareness and public education regarding the damaging effects on the developing fetus.

Prenatal alcohol exposure may affect many more children than what is reported. Pregnant women often underreport substance use because they’re afraid of judgment or punishment. Pregnant women also don’t want to risk losing their baby to child protective services. The majority of pregnant women who abuse a drug during pregnancy may also use legal drugs such as alcohol. This can impact the developing baby and lead to fetal alcohol syndrome, which is discussed below.

The introduction of long-acting oxycodone in the mid-1990s has contributed to a growing trend of opioid misuse (even as a prescription drug). Opioid addiction is currently the most common reason pregnant women seek treatment for drug abuse (38%). Research indicates that pregnant women also seek treatment for the following drugs:

  • Marijuana (20%)
  • Methamphetamines (15.6%)
  • Cocaine (7.4%)
  • Tranquilizers and sedatives (1.2%)
  • Hallucinogens and PCP (0.6%)

The Effects of Drug Use on the Baby

Drugs and alcohol cross the placenta and enter the circulation of the developing fetus. This can result in:

  • Premature birth or premature labor
  • Low birthweight or growth restriction
  • Risk of birth defects involving the heart, kidneys or intestines
  • Defects involving the brain, such as learning problems
  • Miscarriage

Multiple studies have shown an association between pregnant women who used codeine in the first trimester and infants born with congenital heart defects.

Drug Use Can Affect a Baby’s Brain Development

Some studies have shown that cocaine use during pregnancy can result in deficits in certain brain regions. The research suggests problems related to brain growth, as well as in brain regions linked to:

  • Attention
  • Emotion
  • Language
  • Behavior
  • Motor functions
  • Cognitive functions

The effects are not immediately apparent. In fact, many cognitive issues don’t show up until adolescence. For example, some research shows that teens whose mothers used cocaine during pregnancy may have issues in various brain regions associated with language, memory, attention and planning. But more research needs to be done to assess the long-term effects of in-utero exposure. For this reason, it is essential that studies follow up with drug-exposed children into their teen years.

Neonatal Abstinence Syndrome

Heroin withdrawal is not fatal to healthy adults. But fetal death is a risk in pregnant women who do not seek treatment for opioid addiction. When a pregnant woman continues to use opioids (or other legal or illicit substances) the baby can experience neonatal abstinence syndrome, which includes symptoms such as:

  • Excessive or high-pitched crying
  • Diarrhea
  • Vomiting
  • Blotchy skin
  • Stuffy nose or sneezing
  • Sweating
  • Fever
  • Trembling
  • Seizures
  • Hyperactive reflexes
  • Quick breathing
  • Irritability
  • Trouble sleeping
  • Excessive sucking

Fetal Alcohol Spectrum Disorders

Alcohol consumption while pregnant can lead to fetal alcohol spectrum disorders (FASDs). This is the leading, nonhereditary cause of intellectual disability in the Western world. Experts estimate that the full range of FASDs may affect as many as five in 100 schoolchildren. Fetal alcohol syndrome can cause a baby to be born with:

  • Growth problems
  • Small head size
  • Problem with vision or hearing
  • Low body weight
  • Nervous system abnormalities
  • Intellectual disabilities or delayed cognitive development
  • Shorter than average height
  • Poor coordination
  • Heart, kidney or bone problems
  • Problems with sleep
  • Facial deformities

The Impact of Drug Use on a Child Depends on Different Factors

The degree to which illegal or prescription drugs during pregnancy influence the baby’s health and development depends on a few factors, including:

  • The chemical properties of the drug
  • Dosage
  • Timing of exposure
  • Duration of exposure
  • Whether the expectant mother used a drug alongside alcohol or other drugs

The Effects of Drug Use During Pregnancy on the Mother

Substance use in pregnancy can also impact a mother’s physical and emotional health and worsen a mother’s mental health, contributing to depression and anxiety. Experiencing these issues while pregnant can make pregnancy more distressing than it needs to be. If an expectant mother experiences physical issues as a result of drug or alcohol abuse, this can also add undue stress or complicate pregnancies.

After giving birth, the mother may suffer if her baby experiences issues. The guilt, shame and worry may also worsen her mental health and impact her ability to care for her child.

Getting Help During Pregnancy

Testing for substance abuse is one part of effective prevention and should be done with the cooperation of the expecting mother. Prior to pregnancy and early in the first trimester, health professionals should routinely ask women about their use of alcohol and drugs. This should include prescription opioids and other medications used. Healthcare providers must reassure women that their information will be kept confidential.

If you’re struggling with drug abuse during pregnancy, a healthcare provider needs to understand the extent of your problem. This can be done in a couple different ways. The first is through private conversations. The second is through urine tests, which can detect the following drugs:

  • Cocaine
  • Amphetamines
  • Marijuana
  • Barbiturates
  • Opiates

It’s important to note that this method only detects recent drug use and doesn’t provide data on the quantity or frequency of usage. Also, keep in mind that alcohol can be detected by urine screenings, but only within 24 hours of intake. Practicing obstetrician-gynecologists must be informed and should work with addiction specialists to determine appropriate treatment, including detox and rehab.

Moving Forward in Recovery

Motherhood presents both challenges and great joys. Abusing drugs during pregnancy is unhealthy for you and your unborn child. Living drug-free will help you better prepare for personal and parental success.

If you are pregnant—or planning to be—and struggling with drug addiction, talk about it with your physician. Make the decision to start substance abuse treatment and detox sooner rather than later. This will provide your child with a healthier start in life and help prevent dangerous drug-related health complications.

We know pregnancy is difficult and that adding substance abuse to the mix makes it even more of a challenge. But it is possible to detox while pregnant. For the safety of the mother and child, it should be done under the care of a multidisciplinary team with specialized skills and treatment options. The first step is to seek help.

Posted on August 5, 2016 and modified on June 8, 2019

Krisi Herron

Medically Reviewed by

Krisi Herron, LCDC

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