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/Neonatal Effects
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)
Fetal/Neonatal Effects
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/