An estimated 4 percent of pregnant women in the United States admit to illicit drug use during pregnancy, according to the March of Dimes. Perinatal substance abuse is a public health problem with complex issues and enormous social costs. Not all drug use should be stopped abruptly during pregnancy; there may be less harmful effects from weaning off slowly under medical supervision, particularly from opioid drugs. Early intervention and treatment can have a positive impact on outcomes, which can be negative due to the many side effects of drug use.
Risky Behaviors
Drug-addicted mothers may fear exposure and may not seek or comply with prenatal care. Living situations that support illicit drug use are generally unprepared to support the nutritional needs of pregnancy. Co-occurring tobacco and alcohol use may increase the incidence and severity of pregnancy complications. Exposure to violence, sexually transmitted diseases and viral hepatitis can be detrimental to the health of both mothers and babies.
Effects on Fetal and Neonatal Health
The most common effect of all types of maternal drug abuse is pregnancy loss. Methamphetamine, ecstasy and cocaine use have effects on fetal development that are similar to the effects of tobacco use. Constricted blood circulation and oxygen deprivation may lead to limb reduction deformities (missing fingers or toes), spontaneous abortion in the first trimester, miscarriage in later pregnancy, or possible stillbirth. Effects on the placenta cause it to harden, or calcify, which may lead to preterm birth. Premature babies are at risk of respiratory distress, jaundice, infections and developmental delays. Side effects of medications and treatments given to preterm infants may cause permanent hearing or vision loss.
Drug-affected babies are at increased risk of Sudden Infant Death Syndrome (SIDS), especially between 4 and 10 months of age. The extent of learning disabilities and behavior problems due to prenatal drug exposure may not be apparent until the child starts school. The National Institute of Drug Abuse's long-term study found that cocaine-exposed children are more likely to require special education services than non-exposed peers.
When mothers try to quit heroin use during the first trimester of pregnancy, withdrawal symptoms increase the risk of pregnancy loss. Withdrawal symptoms in the final weeks of pregnancy may trigger preterm labor. For this reason, doctors may prescribe methadone, a safer alternative.
Babies born addicted to heroin, methadone, or other opioid drugs experience painful withdrawal symptoms following birth. Body aches, abdominal cramps, tremors, inconsolable crying, difficulty feeding and irritability interfere with the newborn's ability to organize behavior and adjust to extrauterine life.
Effects on Maternal Health
Women who abuse drugs during pregnancy are often anemic. Vitamin and mineral deficiencies are common. Uterine irritability, preterm labor and postpartum hemorrhage may be due to nutritional deficiencies or vascular changes caused by drug abuse. Pain medications used for labor may have insufficient or unexpected effects due to high maternal tolerance for opioid drugs.
Chemically dependent women may be more vulnerable to infection due to being "run down" physically, resulting in longer hospital stays. Mothers who are drug addicted are also at high risk for postpartum depression and typically exhibit a lack of normal bonding behaviors.
