Fetal Drug Exposure


Is there any safe amount of cocaine I can use during pregnancy?

No. Researchers have not determined just how much cocaine it takes to cause birth defects and other adverse outcomes for an exposed baby. It is recommended that cocaine, in any amount or any form, be avoided during pregnancy.

When I use cocaine, does it get into my baby’s body too?

Yes. Cocaine crosses the placenta and enters the baby’s circulation. Cocaine can be found in the urine, meconium (stool), umbilical cord and hair of an exposed newborn. Cocaine is cleared more slowly in the fetus and newborn than in an adult. Therefore, the cocaine remains in the baby’s body for a longer period of time.

I have heard that cocaine can cause a miscarriage. Is this true?

Yes. During the early months of pregnancy, cocaine exposure may increase the risk for miscarriage. Later in pregnancy, cocaine use can cause the placenta to separate 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 the mother and baby. Cocaine may also increase the risk for premature delivery.

Does cocaine cause birth defects?

Studies do not agree as to whether cocaine causes birth defects. Birth defects that have been reported with maternal cocaine use include abnormalities of the brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract. Most babies exposed to cocaine during pregnancy do not have a birth defect. The risk for a birth defect may be greater when the mother has used cocaine frequently during the pregnancy.

Can cocaine cause other problems for the baby?

Yes. Cocaine-exposed infants, especially those exposed near birth, have been found to be more irritable, jittery, and have interrupted sleep patterns, visual disturbances, and problems with sensory stimulation. Some of these complications may last 8 to 10 weeks after birth or even longer.

Cocaine can cause significant central nervous system problems that may not be seen until the child is older. These effects may include problems with sustained attention and behavioral self-control, like increased aggression. Delays in learning, abnormal muscle tone, slower growth rate, language difficulties and an increased need for special education in school-aged children have been reported.

What if my baby is born too early or too small? What will this mean?

Babies of mothers who use cocaine during pregnancy tend to weigh less, be shorter in length, and have smaller heads than babies born without exposure to cocaine. Babies with low birth weight are more likely to die in their first month than are normal weight babies. They are also more likely to have life-long disabilities, including learning, visual, and hearing problems. Since cocaine can reduce the supply of nutrients and oxygen to the baby, even full-term newborns may have low birth weight.

Cocaine may increase the risk for preterm delivery. Babies who are born prematurely often start life with serious health problems, especially breathing difficulties. These babies may also have an intracranial hemorrhage (bleeding in the brain) before or soon after birth, and this can cause permanent brain damage and other disabilities.

If I can’t stop using cocaine during my pregnancy, will my baby be born addicted?

Withdrawal symptoms have been reported in the newborns of mothers who have used cocaine during pregnancy. These may include increased irritability, tremors, muscle stiffness, poor feeding, sleeplessness, and hyperactivity or, in some cases, tiredness. Less frequently observed symptoms have been vomiting, diarrhea, and seizures. These symptoms usually start at 1 to 2 days after birth. Symptoms are most severe on days 2 and 3. Even though it may be difficult, you should seek prenatal care immediately and let your obstetrician know about your cocaine use so that he/she can prepare for the best care for you and your baby after delivery.

What about using cocaine and other drugs at the same time?

Using other drugs, including alcohol or cigarettes, can also harm the baby. The combined effect of cocaine and other drugs may be worse than cocaine alone.

What about cocaine use while I breastfeed?

Cocaine has been found in breast milk. Some infants show signs of cocaine intoxication following nursing. Based on these reports, an infant should not be given breast milk following cocaine use by the mother. You should never apply the cocaine to your nipples to treat soreness. This is extremely dangerous for the baby and is known to cause seizures in the infant. The American Academy of Pediatrics strongly recommends that cocaine not be used during breastfeeding.

Source: OTIS factsheet   http://www.mothertobaby.org/files/cocaine.pdf


How much is known about the effects of marijuana on a pregnancy?

It is difficult to accurately study the effects of marijuana use during pregnancy. Marijuana contains about 400 different chemicals, and some marijuana cigarettes may contain other drugs or pesticides. Some women who use marijuana may also use alcohol, tobacco, or other substances at the same time. Women who use marijuana during pregnancy may have other factors that can increase pregnancy complications, such as lack of prenatal care. Finally, information on the amount, frequency, and timing of marijuana use can be difficult to accurately collect. All of these factors explain why studies looking at marijuana use during pregnancy sometimes find inconsistent results.

Will smoking or ingesting marijuana cause birth defects in my baby?

Most studies have not found an increase in the risk for birth defects among babies prenatally exposed to marijuana. The frequency of birth defects was not higher than expected in the babies of 1246 women who reported “occasionally” smoking marijuana during pregnancy. A few studies have suggested a small increase in the risk for gastroschisis (a rare defect in which the infants’ intestines stick out of an opening in the abdominal wall), and one study reported an increased risk for heart defects among babies prenatally exposed to marijuana. It can be difficult to draw conclusions from these studies because most of the women who used marijuana also used other substances at the same time or had other factors that may have increased their risk for these defects.

While most studies are reassuring, in the absence of studies where women smoked more heavily, it is best to avoid marijuana during pregnancy.

Can marijuana harm the baby in any other way?

The main active chemical in marijuana is delta-9-tetrahydrocannabinol (THC), which is known to cross the placenta during pregnancy. This means it gets into the baby’s system, although how THC may impact a developing baby is unclear. Some studies have suggested that for women who smoke marijuana cigarettes regularly, there is an increased risk for premature birth and lower birth weight, length and head circumference. Babies that are born prematurely or with low birth weight have higher rates of infant deaths, learning problems or other disabilities. Similar to what is seen with cigarette smoking, smoking marijuana may increase carbon monoxide levels in the blood, which can decrease the amount of oxygen the baby receives, and may also affect the growth of the baby.

If I smoke marijuana in the third trimester, can it cause my baby to go through withdrawal after birth?

Some newborns exposed to marijuana have been reported to have temporary withdrawal-like symptoms, such as increased tremors and crying. These symptoms usually go away within a few days.

Can my marijuana smoking affect the brain development of the baby?

Differences in brain activity, behavior, and sleeping patterns of infants and children exposed to marijuana in pregnancy have been reported in some studies. It is believed that these children may have more problems with attention, impulsive behavior, academic performance and short term memory. These problems have been seen more often in children whose mothers were “heavy” marijuana users (smoked one or more marijuana cigarettes per day). The evidence is not conclusive and some studies report conflicting results.

What happens if I use marijuana when I’m breastfeeding?

Marijuana can be passed to infants through their mother’s breast milk. Marijuana may also affect the quality and quantity of breast milk that you make. Although no consistent effects have been noticed in infants exposed to marijuana through breast milk, the American Academy of Pediatrics advises that breastfeeding mothers avoid using marijuana.

Source: OTIS factsheet   http://www.mothertobaby.org/files/marijuana.pdf


Is it safe to use dextroamphetamine or methamphetamine in pregnancy?

Dextroamphetamine, when used for medical reasons, appears to have a low risk for birth defects. However, there are very few studies on prescription use and potential pregnancy complications or intellectual/behavioral problems in the exposed infants. You should speak with your doctor about whether your condition requires the use of dextroamphetamine during pregnancy. In some cases, women are able to taper off the drug and then restart the medication after the pregnancy is over.

Illegal (high dose) dextroamphetamine and methamphetamine should not be used in pregnancy. It can cause miscarriage, prematurity, and problems in the newborn period including jitteriness and trouble sleeping and feeding. Babies can also have neurological effects, such as tremors and too much or too little muscle tone, which can last for several months.

How much dextroamphetamine or methamphetamine does it take to cause problems?

You should take dextroamphetamine in the dose prescribed by your physician. Your doctor will try to keep the dose as low as possible while still appropriately treating your condition.

There is no known safe level of methamphetamine. Since it is an agent of abuse, it is recommended that it be avoided completely during pregnancy. In addition, your baby’s organs develop at different times, and your baby’s brain is developing during your whole pregnancy. Therefore, use at any time in pregnancy could cause problems.

How can methamphetamine hurt my baby?

The most frequently seen problem in babies prenatally exposed to methamphetamine is being born too early and too small. Babies that are born too early can have problems with many of the systems of their body because they have not finished developing. They are at risk for life-long breathing, hearing, vision, and learning problems. Babies that are born too early are more likely to die as infants. There is also some evidence to suggest methamphetamine can increase the chance for sudden infant death syndrome (SIDS), even in babies not born early. There is conflicting evidence on whether methamphetamine increases the chance of birth defects. However, most studies do not find an increased risk for birth defects.

It is not known whether prenatal exposure to methamphetamine can cause behavioral or intellectual abnormalities in older children. Some studies show children whose mothers used more behavior problems. These problems could be caused by other reasons, but methamphetamine use in pregnancy could play a role.

Will my baby be born addicted to methamphetamine?

If a woman uses methamphetamine later in her pregnancy, babies can show signs of withdrawal after they are born. Symptoms include trouble eating, difficulty sleeping or sleeping too much, being very floppy or very tight, and being very jittery. Withdrawal symptoms usually go away within a few weeks, but may require that the baby be admitted to the special care unit for newborns and remain in the hospital for a longer period of time. Some babies show abnormal neurological signs, including tremors and too much or too little muscle tone, for many months. In many cases these symptoms go away on their own, but these babies can benefit from school-based programs such as infant stimulation or physical therapy.

What if I use other drugs besides methamphetamine?

Many women who abuse methamphetamine also use other drugs, alcohol, or cigarettes. The risk to have a baby with problems is higher when methamphetamine is used with other drugs, cigarettes and/or alcohol. These drugs individually can also cause miscarriage, prematurity, small size, and sometimes learning problems and birth defects.

How can I know if methamphetamine may have hurt my baby?

The very best thing that you can do is to stop using methamphetamine and other drugs and alcohol, and to tell your doctor about what you have taken during your pregnancy. Your doctor can offer you a detailed ultrasound to look for birth defects. Your doctor can also help you find treatment or help. There is no pregnancy test that can look for learning problems, and ultrasound exams cannot see all birth defects. Once your baby is born, you should also tell your pediatrician about your history. This way they can look for early warning signs of problems, and get your baby extra help if needed.

What happens if I use dextroamphetamine or methamphetamine while I breastfeed?

Dextroamphetamine and methamphetamine get into breast milk, and are found in the baby’s body and urine. We do not know if this causes the baby to have problems, but the American Academy of Pediatrics recommends that amphetamines not be used while breastfeeding.

A small study of four older infants whose mothers were taking dextroamphetamine for ADHD found no problems in the health of those infants in the short term. The authors commented that should a mother breastfeed while taking a prescription dose of dextramphetamine, the baby’s pediatrician should monitor the baby carefully.

Source:  OTIS Factsheet   http://www.mothertobaby.org/files/methamphetamine.pdf


Can using heroin harm your health?

Yes. Heroin affects your central nervous system and how your brain works. It can make you feel itchy, sleepy and sick to your stomach. Using heroin can cause serious health problems, including:

  • Respiratory failure. This is when too little oxygen passes from your lungs into your blood or when your lungs can’t remove carbon dioxide (a gas) from your blood.
  • Heart and lung infections
  • Infections like HIV or hepatitis (when heroin is injected with a dirty or shared needle)
  • Kidney and liver disease
  • Coma

Can heroin cause problems in pregnancy?

Yes. Using heroin during pregnancy can be dangerous, even deadly. It may cause serious problems, including:

  • Placental abruption. This is a serious condition in which the placenta separates from the wall of the uterus before birth. The placenta supplies the baby with food and oxygen through the umbilical cord. Placental abruption can cause very heavy bleeding and can be deadly for both mother and baby.
  • Premature birth. This is birth that happens too early, before 37 weeks of pregnancy.
  • Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.
  • Neonatal abstinence syndrome (also called NAS). This is a group of conditions a newborn can have if his mother is addicted to drugs during pregnancy. NAS happens when a baby gets addicted to a drug before birth and then goes through drug withdrawal after birth.
  • Stillbirth. This is when a baby dies in the womb before birth, but after 20 weeks of pregnancy.
  • Sudden infant death syndrome (also SIDS). This is the unexplained death of a baby while sleeping.

If you’re pregnant and using heroin, don’t stop taking it without getting treatment from your health care provider first. Quitting suddenly (sometimes called cold turkey) can cause severe problems for your baby, including death. Your health care provider or a drug-treatment center can treat you with drugs like methadone or buprenorphine. These drugs can help you gradually reduce your dependence on heroin in a way that’s safe for your baby.

Source:  http://www.marchofdimes.com/pregnancy/heroin-and-pregnancy.aspx


Smoking during pregnancy

Like drinking too much alcohol or doing drugs, smoking is also very harmful to your health. It can cause serious health conditions including cancer, heart disease, stroke, and gum disease. It can also cause eye diseases that can lead to blindness. Smoking can make it harder for a woman to get pregnant.

How does smoking harm your pregnancy?

Not only is smoking harmful to you, it’s also harmful to your baby during pregnancy. When you smoke during pregnancy, your baby is exposed to dangerous chemicals like nicotine, carbon monoxide and tar. These chemicals can lessen the amount of oxygen that your baby gets .Oxygen is very important for helping your baby grow healthy. Smoking can also damage your baby’s lungs. Women who smoke during pregnancy are more likely to have:

  • An ectopic pregnancy
  • Vaginal bleeding
  • Placental abruption (placenta peels away, partially or almost completely, from the uterine wall before delivery)
  • Placenta previa (a low-lying placenta that covers part or all of the opening of the uterus)
  • A stillbirth

Does smoking during pregnancy harm your baby?

Yes. Babies born to women who smoke during pregnancy are more likely to be born:

  • With birth defects such as cleft lip or palate
  • Prematurely
  • At low birth weight
  • Underweight for the number of weeks of pregnancy

Babies born prematurely and at low birth weight are at risk of other serious health problems, including lifelong disabilities (such as, intellectual disabilities and learning problems), and in some cases, death.

What is secondhand smoke?

Breathing in someone else’s smoke is also harmful. Secondhand smoke during pregnancy can cause a baby to be born at low birth weight. Secondhand smoke is also dangerous to young children. Babies exposed to secondhand smoke:

  • Are more likely to die from SIDS (Sudden Infant Death Syndrome)
  • Are at greater risk for asthma, bronchitis, pneumonia, ear infections, respiratory symptoms
  • May experience slow lung growth

What is third hand smoke?

New research shows that third hand smoke is another health hazard. Third hand smoke is made up of the toxic gases and particles left behind from cigarette or cigar smoking. These toxic remains, which include lead, arsenic and carbon monoxide, cling to things like clothes, hair, couches and carpets well after the smoke from a cigarette or cigar has cleared the room. That’s why you often can tell a smoker by the smell of cigarettes or cigars that linger on his clothing or in his home or car. Things like cracking the car window down while you smoke or smoking in another room aren’t enough to keep others away from the harm caused by cigarettes or cigars. Breathing in these toxins at an early age (babies and young children) may have devastating health problems like asthma and other breathing issues, learning disorders and cancer. It’s important that expecting moms and their children do their best to keep away from places where people smoke.

Why should you quit smoking?

The sooner you quit smoking during pregnancy, the healthier you and your baby will be. It’s best to quit smoking before getting pregnant. But if you’re pregnant, this would be a great opportunity to kick the habit. Some women may mistakenly think that switching to “light” or “mild” cigarettes are a safer choice during pregnancy. Other pregnant women may want to cut down on smoking rather than quitting altogether. It’s true that the less you smoke, the better off baby will be. But quitting smoking is the best way to help ensure a healthy pregnancy and healthy baby. Besides, when you quit smoking, you’ll never again have to go outside and look for a place to smoke. You’ll also have:

  • Cleaner teeth
  • Fresher breath
  • Fewer stain marks on your fingers
  • Fewer skin wrinkles
  • A better sense of smell and taste
  • More strength and ability to be more active

What are some tips to quit?

If you’re trying to quit smoking, these tips may be helpful:

  • Write down your reasons for quitting
  • Look at the list when you are tempted to smoke.
  • Choose a “quit day.” On that day, throw away all your cigarettes or cigars, lighters and ashtrays.
  • Drink plenty of water.
  • Keep your hands busy using a small stress ball or doing some needlework.
  • Keep yourself occupied, too. Try going for a walk or doing chores to keep your mind off of cravings.
  • Snack on some raw veggies or chew some sugarless gum to ease the need to have something in your mouth.
  • Stay away from places, activities or people that make you feel like smoking.
  • Ask your partner or a friend to help you quit. Call that person when you feel like smoking.
  • Ask your health care provider about quitting aids such as patches, gum, nasal spray and medications. Don’t start using these without your health care provider’s okay, especially if you’re pregnant.
For more information

www.smokefree.gov (1-800-Quit-Now)

Source: http://www.marchofdimes.com/pregnancy/smoking-during-pregnancy.aspx

Prescription drug abuse

Sometimes you may need prescription drugs to treat a health condition. A prescription is an order for medicine given by a health care provider.

Prescription drug abuse is when you use a prescription drug in a way other than ordered by your health care provider. Prescription drug abuse is a serious and growing problem in the United States. Nearly 1 out of 5 people in this country say they abuse prescription drugs. Prescription drugs are the second most commonly abused drugs after marijuana.

If you’re pregnant, it’s OK to take prescription drugs with your health care provider’s OK. But abusing prescription drugs during pregnancy can cause serious problems for both you and your baby. If you’re pregnant and you abuse prescription drugs, tell your health care provider right away. She can help you get treatment to quit.

If you’re not pregnant, quit abusing prescription drugs before you get pregnant.

How are prescription drugs abused?

When your provider gives you a prescription for medicine, he tells you exactly how much to take, how often to take it and how long to take it. Examples of prescription drug abuse include:

  • Taking more medicine than your provider says you can take
  • Taking the medicine with alcohol or other drugs
  • Using someone else’s prescription medicine

The most commonly abused prescription drugs are central nervous system(CNS) depressants (also called sedatives or tranquilizers), opioids and stimulants.

Can abusing prescription drugs harm your health?

Yes. Prescription drug abuse may cause health problems, including:

  • Breathing problems
  • An irregular heartbeat
  • Dangerously  high body temperature
  • Seizures

Can abusing prescription drugs cause problems during pregnancy?

Yes. Abusing these drugs during pregnancy my cause problems for your baby, including:

  • Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.
  • Birth defects. These are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works.
  • Neonatal abstinence syndrome (also called NAS). This is a group of conditions a newborn can have if his mother is addicted to drugs during pregnancy. NAS happens when a baby gets addicted to a drug before birth and then goes through drug withdrawal after birth.
  • Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.

Source:  http://www.marchofdimes.com/pregnancy/prescription-drug-abuse.aspx