According to the Substance Abuse and Mental Health Services Administration, results from a 2001 national household survey on drug abuse found that 2.5 million women are estimated to be alcohol dependent and 12 percent of pregnant women admit to drinking alcohol. The same study reported that 15 percent of pregnant women aged 15 to 17 reported using illicit drugs. The American College of Obstetricians and Gynecologists note in their comittee opinion that 11 percent of pregnant women smoke. These addictive behaviors cost society millions of dollars each year and contribute to significant neonatal morbidity and mortality.
Alcohol
The American College of Obstetricians and Gynecologists strongly states in their committee opinion that alcohol "puts the fetus at risk for fetal alcohol syndrome which is the leading cause of mental retardation in the United States." The characteristics of fetal alcohol syndrome are facial anomalies, small brains, heart defects and joint problems. Mental retardation, hyperactivity, developmental delays and poor coordination are also associated with fetal alcohol syndrome.
Tobacco
Spontaneous abortion, fetal death, placental separation from the uterus, preterm delivery and premature rupture of the membranes are associated with smoking. Women who smoke have double the risk of having a low birth-weight baby. In Precis, The American College of Obstetricians and Gynecologists notes that recently smoking has been identified as a risk for congenital abnormalities such as cleft lip and plate in certain women.
Cocaine
ACOG is quite clear about the studies regarding cocaine use in pregnant women. Babies born to mothers who abuse cocaine during pregnancy are at risk for heart problems, skull defects, intestinal abnormalities and brain cysts. They also exhibit neurobehavioral problems particularly irritability and are difficult to console. Intrauterine growth restriction is another complication of cocaine use.
Marijuana, Amphetamines, Heroin
In a 1990 "New England Journal of Medicine" article, Dr.Chasnoff and colleagues note that 15 percent of pregnant women use marijuana, whose active ingredient, delta-9-tetrahydrocannabinol, causes birth defects in animals, but there is no evidence that marijuana is associated with human abnormalities. Some studies have shown that exposed fetuses have lower birth weights while others have shown no effect.
According to the premier text on obstetrics," William's Obstetrics," it is noted that several studies have shown that amphetamines have not been shown to cause congenital defects. But these drugs have been associated with fetal growth restriction. Babies born to mothers who use amphetamines can suffer through a neonatal withdrawal syndrome characterized by increased muscle tone, tremors, and a high pitched cry, according to ACOG.
Heroin is associated with perinatal death, fetal growth restriction and severe perinatal complications. Forty to 80 percent of babies born to mothers addicted to heroin will suffer a withdrawal syndrome, which is characterized by tremors, irritability, sneezing, vomiting, fever, diarrhea and occasionally seizures according to "Williams Obstetrics."
References
- "2006 Compendium of Selected Publications. The American College of Obstetricians and Gynecologists"; 2006
- "Precis"; An update in obstetrics and gynecology; The American College of Obstetrics and Gynecology; 2005
- "Williams Obstetrics"; F, Levenol et al; 2005
- Summary of Findings: 2001 National Household Survey on Drug Abuse: volume 1. Substance Abuse and Mental Health Services Administration. 2002
- "New England Journal of Medicine"; The prevalence of illicit drug or alcohol use during pregnancy and the discrepancies in mandatory reporting in Pinellas County, Florida; Chasnoff et al; 1990
