Twenty-five studies fulfilled all of the specific requirements and were included in this review. Most research covered prenatal alcohol exposure. Other substances, however, included cocaine, marijuana, opiates, and poly-substances. Results showed that prenatal exposure to alcohol has long-term cognitive, behavioral, social, and emotional developmental consequences depending on amount and timing of exposure in utero. Less evidence exists for long-term consequences of exposure in utero to other substances than alcohol. However, recent brain-imaging studies have provided important evidence of serious effects of other substance exposure on the developing brain and recent follow-up studies have found an association with deficits in language, attention, areas of cognitive performance and delinquent behavior in adolescence.

Substance exposure in utero has been associated with physical birth defects and increased risk of regulatory and neuropsychological difficulties. The aims of this study were to describe women who use substances and are in treatment with respect to the type and number of substances used during pregnancy, as well as their background, and to examine the effect substance use has on gestational age, birth weight, and the development of neonatal abstinence syndrome at birth. A sample of 161 pregnant women and their 163 newborn children were included. The results indicate that the children whose mothers continued to use substances throughout their pregnancies were born at a lower gestational age (Chi-Square = 15.1(2), P < .01); children exposed to poly-substances in utero were more affected than those exposed to only alcohol and those with no substance exposure. The same children were more vulnerable to the development of neonatal abstinence syndrome at birth (Chi-Square = 51.7(2), P < .001). Newborns who were exposed primarily to alcohol in utero were at a significant risk of being born with low birth weight (Chi-Square = 8.8(2), P < .05) compared with those exposed to other types of substances. More than 50% of the mothers ceased using any substances (with the exception of tobacco) by birth, indicating that the treatment program did have an interventional effect on the mothers. The mothers' ability to either cease or decrease the use of substances during pregnancy appears to have direct positive effect on their newborns.

Prenatal substance exposure is associated with physical birth defects and increased risk of regulatory and neuropsychological difficulties of children born to mothers using substances while pregnant. Myriad factors, such as maternal psychopathology, stress, and poor living circumstances, may influence childhood development in addition to the teratological effect of prenatal substance exposure. This study explores the long-term developmental consequences in children from birth to age 7 born to women using substances and are in treatment. A series of t tests were performed to explore group effects on the cognitive and social dimensions of Griffiths Mental Development Scales compared with Swedish norms. The results showed significant effects on eye and hand coordination in children aged birth to 7 years and on hearing and speech, practical reasoning, and the general quotient in children aged 3 to 7 years. Children who were exposed primarily to alcohol in utero scored significantly lower on the personal and social skills subscale, eye and hand coordination subscale, and the general quotient than children exposed primarily to substances other than alcohol. These effects did not appear to be mediated by the mothers' social background or treatment history. The results suggest that children who are exposed to substances, in particular alcohol, in utero are vulnerable overall, but especially in eye and hand coordination and personal and social skills.