Drug Use and Pregnancy

If you're pregnant or thinking about getting pregnant and want a healthy baby, then it's very important to avoid drug use during pregnancy. Illegal drugs such as marijuana, cocaine, and methamphetamine aren't the only drugs that are harmful to fetal development; Commonly used over-the-counter medicines, along with substances such as caffeine and alcohol, can have lasting effects on an unborn child.

Why are pregnant women warned not to use drugs?

It's possible that you may not have a serious or long-lasting problem after using drugs. But the same is not always true for a fetus. Drug-using mothers often give birth to "drug babies." These children have a host of developmental problems.

Studies show that using drugs -- legal or illegal -- during pregnancy has a direct impact on the fetus. If you smoke, drink alcohol, or ingest caffeine, so does the fetus. If you use marijuana or crystal meth, your fetus also feels the impact of these dangerous drugs. And if you are addicted to cocaine -- also called coke, snow, or blow -- you're not only putting your own life on the line, but you are risking the health of your unborn baby.. The consequences of using cocaine include heart attacks, respiratory failure, strokes, and seizures. And these life-threatening health problems can also be passed to an unborn baby.

Taking drugs during pregnancy also increases the chance of birth defects, premature babies, underweight babies, and stillborn births. Exposure to drugs such as marijuana -- also called weed, ganja, dope, or pot -- and alcohol before birth has been proven to cause behavior problems in early childhood. These drugs can also affect the child's memory and attentiveness. In addition, some findings show that babies born to women who use cocaine, alcohol, or tobacco when they are pregnant may have brain structure changes that persist into early adolescence.

While cocaine's effects are usually immediate, the effect it can have on a fetus may last a lifetime. Babies born to mothers who smoke crack cocaine during pregnancy -- so-called ''crack babies'' -- usually have their own set of physical and mental problems. According to the National Institute on Drug Abuse, exposure to cocaine in the womb can lead to subtle, yet significant, deficits later in children. These deficits usually show up in areas such as cognitive performance, information-processing, and attention to tasks. These are areas that are vital for success not just in school, but in life.

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Which drugs have the most serious consequences for the fetus?

Taking almost any drug during pregnancy can have serious consequences for the fetus. For instance, babies who are exposed to cocaine have a tendency to have smaller heads that indicate a lower IQ. Cocaine-exposed babies have a higher risk of birth defects that impact the urinary tract or heart. Cocaine may also cause a stroke in an unborn fetus, resulting in brain damage or even death.

Using cocaine or methamphetamine -- also called speed, Tina, crank, or ice -- increases the risk of miscarriage early in the pregnancy. Later in the pregnancy, these illicit drugs may cause pre-term labor and low birth weight, as well as babies who are irritable and have feeding difficulties.

Pregnant women who smoke marijuana face a higher risk of premature birth and low birth weight. Smoking pot may cause developmental delays in the child. And after delivery, babies who have been exposed to marijuana seem to undergo withdrawal symptoms with excessive crying and trembling.

What about cigarette smoking during pregnancy?

Cigarette smoking causes serious illness and premature death in the general population. But pregnant women who smoke pass the nicotine and other carcinogenic chemicals to the growing fetus. According to the Centers for Disease Control, mothers who smoke early in their pregnancy are more likely to deliver babies that have several different heart defects, including septal defects – essentially a hole in the wall between the heart’s left and right chambers. Sadly, most infants with congenital heart defects die in the first year of life. Those infants who survive often face lengthy hospital stays and numerous surgeries along with a lifetime of disabilities.

Women who smoke are also more likely to have placenta problems. This is a serious concern because the placenta provides nourishment to the baby in the womb. Smokers also have low-birth-weight babies, premature deliveries, and babies with cleft palate. In addition, smoking during pregnancy and after delivery is one of the causes associated with sudden infant death syndrome (SIDS).

Does drinking during pregnancy cause fetal alcohol syndrome?

Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) refer to a range of disorders caused by drinking alcohol during pregnancy. Fetal alcohol syndrome can cause abnormal facial features, growth deficiency, and problems with the central nervous system. Children with fetal alcohol syndrome may also have learning disabilities, attention span disorders, and other physical disabilities, including vision and hearing problems.

There is no "safe" limit of alcohol consumption during pregnancy. Some studies have found that small amounts of alcohol consumption can have the same adverse effects on the fetus as binge drinking.

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Why is caffeine considered a "drug" during pregnancy?

Caffeine is legal and prevalent in foods such as chocolate and drinks such as coffee and sodas. But experts claim it's still a drug and should be limited. Caffeine has been a controversial subject in FDA guidelines. In the early 1980's, the FDA released a study that stated caffeine use had toxic results in studies of rats. However, this warning has since been loosened a bit.

Pregnant women who need caffeine should regulate it. It can cause low birth weight and irritability if taken in large quantities.

Are prescription drugs harmful to the unborn fetus?

They might be. It's necessary to monitor intake of prescription drugs and over-the-counter (OTC) medications if you are pregnant. However, because it's unethical to test drugs on pregnant women, the effects of many drugs during pregnancy simply aren't known.

Pharmaceutical companies are required to report any problems with medications to the FDA. You and your doctor can also report problems with a medication to the FDA. The FDA has guidelines for drug companies to follow in labeling medications about their effect on pregnancy and the growing fetus. By reading the product information, you can learn more about how the medication may affect your pregnancy.

The FDA requires drug companies to conduct special studies called pregnancy registries. Women who take a certain medication may enroll in the study. After delivery, their babies are compared to babies of moms who didn't take the medication during pregnancy. When the data is compiled, these studies can help agencies monitor the effects of medications after they are made available.

Some women must take drugs during pregnancy. They may need to take them for pain or for a serious condition such as asthma, epilepsy, hypertension or depression. If you are concerned about using a prescription or over-the-counter medication during pregnancy, talk with your doctor and get more information about the drug's safety.

How many pregnant women abuse drugs each year?

According to the Substance Abuse and Mental Health Services Administration's 2013 National Survey on Drug Use and Health, 5.4 percent of pregnant women between ages 18-44 had used alcohol during their first trimester, 4.8 percent in their second trimester, and 2.4 percent in the last trimester of pregnancy. Similar numbers were seen with marijuana, cigarette, and binge alcohol use.

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Are any drugs safe during pregnancy?

While a few prescription and over-the-counter medications are considered "safe" during pregnancy, most drugs are not. If you are taking medications for medical purposes, here are some safety tips to follow when you are pregnant:

  • Always read the medication label. Many of the products will tell you on the label if they are safe for use while pregnant. If you are unsure about taking an OTC product, call your doctor.
  • Natural dietary supplements -- herbs, amino acids, minerals, mega-vitamins -- might be considered natural, but that does not mean they are safe. Talk with your health care provider before taking any unproven or "natural" remedy.
  • According to the FDA, aspirin and ibuprofen should not be taken during the last 3 months of your pregnancy unless you are instructed by your doctor to take it. These drugs can cause problems for your baby or cause problems when you are in labor.
  • Talk with your doctor about special prenatal vitamins that are safe for mom and baby. OTC vitamins may have doses that are too high.
WebMD Medical Reference Reviewed by Kecia Gaither, MD, MPH on September 18, 2014

Sources

SOURCES:

Substance Abuse and Mental Health Services Administration - National Survey on Drug Use and Health, September 2014.

National Toxicology Program: "Center for the Evaluation of Risks to Human Reproduction (CERHR)."

March of Dimes: "Illicit Drug Use During Pregnancy."

Medline Plus: "Pregnancy and Substance Abuse."

CDC: "Smoking Early In Pregnancy Raises Risks Of Heart Defects In Newborns."

FDA: "Pregnancy and the Drug Dilemma."

National Toxicology Program: "Center for the Evaluation of Risks to Human Reproduction (CERHR)."

Bruce, D, PhD. Making a Baby: Everything You Need to Know to Get Pregnant, Ballantine Books, 2000.

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