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Zero Exposure Project, An Initiative of the Healthy Start Coalition of Hillsborough County Information & Services - Illicit Drugs
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Alcohol Consumption During Pregnancy and Provider Screening

Drug Use During Pregnancy

A mother taking illegal drugs during pregnancy increases her risk for anemia, blood and heart infections, skin infections, hepatitis, and other infectious diseases. She also is at greater risk for sexually transmitted diseases.

Heroin, cocaine, and other addictive drugs are not necessarily deforming substances, but use can cause withdrawal in the newborn as well as growth retardation in the unborn baby. Alcohol abuse can cause what's called Fetal-Alcohol Syndrome, associated with deformed teeth and facial features and mental retardation. Marijuana, like cigarettes, has many chemicals in it besides THC. If you get stoned, your baby gets stoned--all at a time when neural cells are busy developing so that they can handle all of the neurotransmitters used in proper central nervous system functioning.

A laboratory test, called a chromatography, performed on a woman's urine can detect many illegal drugs, including marijuana and cocaine. Marijuana and cocaine, as well as other illegal drugs, can cross the placenta. Marijuana use during pregnancy may be linked to behavioral problems in the baby. Cocaine use can lead to premature delivery of the fetus, premature detachment of the placenta, high blood pressure, and stillbirth.

A woman's drug use can affect both her fetus and her newborn. Most drugs cross the placenta--the organ that provides nourishment to the fetus. Some can cause direct toxic (poisonous) effects and drug dependency in the fetus. After birth, some drugs can be passed to the baby through breast-feeding.

Drugs can cause problems throughout your pregnancy. For example, the early part of pregnancy is the most critical for the health of a fetus. This is when the main body systems are forming. Using drugs during this time can cause severe damage. Drugs can have harmful effects on the fetus at any time during the pregnancy, their nature depending on the timing of exposure. During the first two weeks of development, the embryo is thought to be resistant to any teratogenic effects of drugs.

The critical period of embryonic development, when the major organ systems develop, starts at about 17 days postconception and is complete by 60 to 70 days. Exposure to certain drugs during this period (17 to 70 days) can cause major birth defects. However, some drugs can interfere with functional development of organ systems and the central nervous system in the second and third trimesters and produce serious consequences. During the last 12 weeks of pregnancy, drug use poses the greatest risk for stunting fetal growth and causing pre-term birth.

How Drugs Affect The Pregnant Woman:

  • Poor appetite
  • Trouble sleeping at night
  • Early (premature) labor
  • Hard to make decisions or plans
  • More chances of infections (transmitted through sex)
  • Water breaks too early
  • Not able to recognize or cope with normal changes during pregnancy
  • Sudden bleeding

How Drugs Affect The Unborn Baby:

  • Low weight at birth
  • Early delivery or miscarriage
  • Growth and development may be slow
  • Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effect (FAE)
  • Mental retardation
  • Heart problems
  • Defects of the face and body
  • Death

How Drugs Affect You and Your Baby After Delivery:

  • Withdrawal symptoms that may keep you or your baby in the hospital longer
  • Sudden Infant Death Syndrome (SIDS)
  • Greater chance of feeling depressed after having the baby
  • Trouble being a parent
  • Hard to make decisions or plans
  • Hard to cope with your new baby's needs (i.e. eating, sleeping, crying)
  • Hard to bond with your baby
  • Hard to hold a job

Information is from the Narconon Southern California Website


Nearly 4 percent of pregnant women use illicit drugs such as marijuana, cocaine, Ecstasy and other amphetamines, and heroin, according to the National Survey on Drug Use and Health. These and other illicit drugs may pose various risks for unborn babies and pregnant women. Some of these drugs can cause a baby to be born too small or to have withdrawal symptoms, birth defects, or learning or behavioral problems. However, because most pregnant women who use illicit drugs also use alcohol and tobacco (which also pose risks to unborn babies), it often is difficult to determine which health problems are caused by a specific illicit drug.

What are the risks with use of cocaine during pregnancy?
Cocaine use during pregnancy can affect a pregnant woman and her unborn baby in many ways. During the early months of pregnancy, it may increase the risk of miscarriage. Later in pregnancy, it can trigger preterm labor (labor that occurs before 37 weeks of pregnancy) or cause the baby to grow poorly. As a result, cocaine-exposed babies are more likely than unexposed babies to be born with low birthweight (less than 5½ pounds). Low-birthweight babies are 20 times more likely to die in their first month of life than normal-weight babies, and face an increased risk of lifelong disabilities such as mental retardation and cerebral palsy. Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains.

Some studies suggest that cocaine-exposed babies are at increased risk of birth defects, including urinary-tract defects and, possibly, heart defects. Cocaine also may cause an unborn baby to have a stroke, which can result in irreversible brain damage or a heart attack, and sometimes death.

Cocaine use also may cause the placenta to pull away from the wall of the uterus before labor begins. This condition, called placental abruption, can lead to extensive bleeding and can be fatal for both mother and baby. (Prompt cesarean delivery, however, can prevent most deaths.)

Babies who were regularly exposed to cocaine before birth may score lower than unexposed babies on tests given at birth to assess the newborn’s physical condition and overall responsiveness. They may not do as well as unexposed babies on measures of motor ability, reflexes, attention and mood control, and they appear less likely to respond to a human face or voice.

Babies who are regularly exposed to cocaine before birth sometimes have feeding difficulties and sleep disturbances. As newborns, some are jittery and irritable, and they may startle and cry at the gentlest touch or sound. Therefore, these babies may be difficult to comfort and may be described as withdrawn or unresponsive. Other cocaine-exposed babies “turn off” surrounding stimuli by going into a deep sleep for most of the day. Generally, these behavioral disturbances are temporary and resolve over the first few months of life. Some studies suggest that cocaine-exposed babies have a greater chance of dying of sudden infant death syndrome (SIDS). However, other studies suggest that poor health practices that often accompany maternal cocaine use (such as use of other drugs) also may play a major role in these deaths.

What is the long-term outlook for babies who were exposed to cocaine before birth?
Some studies suggest that most children who are exposed to cocaine before birth have normal intelligence. This is encouraging, in light of earlier predictions that many of these children would be severely brain damaged. A 2002 study at Harvard Medical School and Boston University found that children up to age 2 who were heavily exposed to cocaine before birth scored just as well on tests of infant development as lightly exposed or unexposed children. However, other studies suggest that cocaine may sometimes affect mental development, possibly lowering IQ levels.

A 2002 study at Case Western Reserve University found that cocaine-exposed 2-year-olds were twice as likely as unexposed children from similar low socioeconomic backgrounds to have significant delays in mental development (14 percent and 7 percent, respectively). It is not known whether these children will continue to have learning problems when they reach school age.

Studies are inconclusive regarding the risk of learning and behavioral problems. Studies from the National Institute on Drug Abuse suggest that most adolescents who were exposed to cocaine before birth seem to function normally. However, some may have subtle impairments in the ability to control emotions and focus attention that could put them at risk of behavioral and learning problems. Other studies suggest that cocaine exposure may adversely affect language abilities. Researchers continue to follow cocaine-exposed children through their teen years to clarify their long-term outlook.

What are the risks with use of marijuana during pregnancy?
Some studies suggest that use of marijuana during pregnancy may slow fetal growth and slightly decrease the length of pregnancy (possibly increasing the risk of premature delivery). Both of these factors can increase a woman’s chance of having a low-birthweight baby. These effects are seen mainly in women who use marijuana regularly (six or more times a week).

After delivery, some babies who were regularly exposed to marijuana in the womb appear to undergo withdrawal-like symptoms including excessive crying and trembling.

Couples who are planning pregnancy also should keep in mind that marijuana can reduce fertility in both men and women, making it more difficult to conceive.

What is the long-term outlook for babies exposed to marijuana before birth?
There have been a limited number of studies following marijuana-exposed babies through childhood. Some did not find any increased risk of learning or behavioral problems. However, others found that children who are exposed to marijuana before birth are more likely to have subtle problems that affect their ability to pay attention and to solve visual problems. Exposed children do not appear to have a decrease in IQ.
What are the risks with use of Ecstasy and other amphetamines during pregnancy?
The use of Ecstasy has increased dramatically in recent years. To date there have been few studies on how the drug may affect pregnancy. One small study did find a possible increase in congenital heart defects and, in females only, of a skeletal defect called clubfoot. Babies exposed to Ecstasy before birth also may face some of the same risks as babies exposed to other types of amphetamines.

Another commonly abused amphetamine is methyl amphetamine, also known as speed, ice, crank and crystal meth. Some, but not all, studies suggest that this drug may cause an increased risk of birth defects, including cleft palate, and heart and limb defects. It also appears to contribute to pregnancy complications including maternal high blood pressure  which can slow fetal growth and cause other complications for mother and baby), premature delivery, and excessive bleeding in the mother following delivery.

After birth, babies who were exposed to amphetamines appear to undergo withdrawal-like symptoms, including jitteriness, drowsiness and breathing problems.

What is the long-term outlook for babies exposed to Ecstasy and other amphetamines before birth?
The long-term outlook for these children is not known. One very small study (only 12 children) found that 7- and 8- year-old children who were exposed to Ecstasy before birth had altered levels of a specific brain chemical. However, it is not known whether this has any effect on learning or behavior, as there was no evidence of problems in these children. One recent animal study did find that rats that were exposed to Ecstasy during the period that corresponds to the third trimester of human pregnancy suffered life-long deficits in memory and learning. It is not yet known whether this will hold true for exposed children.

What are the risks with use of heroin during pregnancy?
When a pregnant woman uses heroin, she and her baby may face many serious complications. Common pregnancy complications associated with heroin use include miscarriage, placental abruption, poor fetal growth, premature rupture of the membranes (the woman’s water breaks too soon), premature delivery and stillbirth. As many as half of all babies of heroin users are born with low birthweight. These babies, most of whom are premature, often suffer from serious prematurity-related health problems during the newborn period, including breathing problems and brain bleeds, sometimes leading to lifelong disabilities.

Most babies of heroin users suffer from withdrawal symptoms after birth, including fever, sneezing, trembling, irritability, diarrhea, vomiting, continual crying and, occasionally, seizures. Babies exposed to heroin before birth also face a ten-fold increased risk of sudden infant death syndrome (SIDS).

While heroin can be sniffed, snorted or smoked, most users inject the drug into a muscle or vein. Pregnant women who share needles are at risk of contracting HIV (the virus that causes AIDS) and passing it on to their babies.

A pregnant woman who uses heroin should not attempt to suddenly stop taking the drug. This can put her baby at increased risk of miscarriage or premature birth. She should consult a doctor or drug treatment center about treatment with a drug called methadone. Although infants born to mothers taking methadone also may show some signs of dependence on the drug, they can be safely treated in the nursery and generally do far better than babies born to women who continue to use heroin.

What is the long-term outlook for babies exposed to heroin before birth?
The outlook for these children depends on a number of factors, including whether they suffered serious prematurity-related complications. Some studies suggest that children exposed to heroin before birth are at increased risk of low IQ (in the mentally retarded range) and of serious behavioral problems. However, socioeconomic factors also may play an important role in a child’s outlook. One study found that heroin-exposed children who were adopted soon after birth were no more likely to have developmental delays than unexposed children, though exposed children who were raised by their biological parents were at increased risk.

How can a woman protect her baby from the dangers of illicit drugs?
Birth defects and other problems caused by illicit drugs are completely preventable. The March of Dimes advises women who use illicit drugs to stop before they become pregnant or to delay pregnancy until they believe they can avoid the drug completely throughout pregnancy. The March of Dimes also encourages pregnant women who use illicit drugs (with the exception of heroin) to stop using the drug immediately, because of the harm continued drug use may cause. Women who use heroin should consult their health care provider or a drug treatment center about methadone treatment.

Information is from the March of Dimes Website

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