Substance Use During Pregnancy and Postnatal Outcomes

Abstract

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.

Mental and Behavioral Disorders Due to Substance Abuse and Perinatal Outcomes: A Study Based on Linked Population Data in New South Wales, Australia

“…Polysubstance use is common among pregnant women and the effects on perinatal outcomes are more significant. A study in Denmark reported that polysubstance use was associated with poorer perinatal outcomes compared with only alcohol or with no substance exposure [15]. …”

Patterns of polydrug use among pregnant substance abusers

“…In this study a maximum of five drugs was recorded, and 41% of the women used 1-2 drugs and 59% used three or more. A comparable Danish study recorded up to six drugs used during pregnancy for a group of 161 women in treatment, revealing exactly the same distribution between categories; 42% used 1-2 drugs and 58% used three or more (Irner et al, 2012). This is an important observation given that the combination of different substances may have particularly detrimental effects (Høiseth, Andås, Bachs, & Mørland, 2014).…”

“…The smoking rate in this study was 59%, but it is likely to have been substantially higher; daily smoking rates among female clients and younger clients in compulsory care are around 90% (National Board of Institutional Care, 2016a). In a Danish study of pregnant women the smoking rate was 84% (Irner et al, 2012), and all of the women in the Finnish study were defined as ''excessive smokers'' (Pajulo et al, 2012). These exceptionally high levels need to be addressed clinically, politically and scientifically.…”

“…The study is therefore also based on secondary data, i.e., client records and registry data with all their flaws and inadequacies. It was, for example, not possible to study dose and frequency of drug use or smoking (Irner et al, 2012). Moreover, data consisted of a retrospective mix of professional assessments and self-reports, often presented in a haphazard manner.…”

“…There is a risk of an attention bias towards drugs with a clear link between cause and effect and a diagnostic definition (FASD), or where there is a distinct medical treatment option available (such as OMT). In both instances it is easy to lose sight of the entirety of drugs used and the general life situation including poor housing conditions, low income, poor nutrition, exposure to violence, lack of social support, mental health problems and so forth (Irner et al, 2012;Powis et al, 2000;Velez et al, 2006).…”