Approximately 5.9 percent of pregnant women admit to using illicit drugs or nonprescribed narcotics during pregnancy, according to the 2012 National Survey on Drug Use and Health. Many more women take prescribed selective serotonin reuptake inhibitors, or SSRI, antidepressants. Illicit drugs or medications taken during pregnancy pass through the placenta to the fetus. In some cases, a newborn develops withdrawal symptoms that can last several weeks. Symptoms vary depending on the type of drug taken.
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Neonatal Abstinence Syndrome
A newborn whose mother took opioid drugs -- such as codeine, hydrocodone (Vicodin, Lortab), hydromorphone (Dilaudid, Exalgo), morphine (MS Contin) and heroin -- may develop neonatal abstinence syndrome, or NAS. Fifty-five to 94 percent of newborns exposed prenatally to opioid drugs experience symptoms of NAS, notes a February 2012 American Academy of Pediatrics policy report. Nervous system symptoms of NAS include irritability, jitteriness, a high-pitched cry, tremors, rapid heartbeat, difficulty sleeping, frequent sneezing and yawning, hyperactive reflexes and possibly seizures. Uncoordinated sucking and swallowing, difficulty feeding, poor weight gain and diarrhea are common digestive system symptoms. Other symptoms include nasal stuffiness, sweating, mottled skin color and difficulty maintaining a normal temperature.
SSRI Withdrawal Symptoms
Between 7 to 13 percent of pregnant women take antidepressants, according to an August 2013 article published in "Contemporary OB/GYN." The authors note that a newborn whose mother took SSRIs during the last trimester of pregnancy has a 10 to 30 percent chance of experiencing symptoms of poor neonatal adaptation syndrome, or PNA. Some symptoms mimic those of infants withdrawing from opioid drugs, including jitteriness, seizures and an exaggerated startle reflex. Other symptoms include a weak cry, increased motor activity, poor muscle tone, low blood sugar and a yellowish discoloration of the skin.
Non-Narcotic Withdrawal Symptoms
Non-narcotic drugs, such as alcohol, barbituates and diazepam (Valium), can also cause withdrawal symptoms in a newborn. Alcohol, barbiturate and hydroxyzine (Atarax) withdrawal causes many of the same symptoms as opioid withdrawal. Marijuana exposure typically does not cause withdrawal symptoms in newborns, although there may be long-term effects. Cocaine exposure before birth may not cause symptoms after birth, although some infants exhibit symptoms similar to those of babies exposed to opioids.
Symptoms of drug withdrawal in newborns usually appear within the first 3 days after delivery, although it can take longer. The timing varies according to the dose of drug the mother took, when she last took it and the type of drug taken. Opioid withdrawal symptoms typically appear within 24 to 26 hours, while alcohol withdrawal begins more quickly, within 3 to 12 hours. Symptoms of SSRI withdrawal develop within hours to days, while barbiturate withdrawal symptoms can take 1 to 14 days to appear.
- Pediatrics: Neonatal Drug Withdrawal
- University of Iowa Children's Hospital: Identifying Neonatal Abstinence Syndrome ( NAS) and Treatment Guidelines
- Indian Journal of Pediatrics: Neonatal Abstinence Syndrome
- Contemporary OB/GYN: Use of Selective Serotonin Reuptake Inhibitors During Pregnancy
- Substance Abuse and Mental Health Services Administration: Results from the 2012 National Survey on Drug Use and Health -- Summary of National Findings