Substance use in pregnancy: The medical challenge

Abstract

Substance use contributes significantly to the global burden of disease. Growing numbers of women use nicotine, alcohol, and illicit substances. Women are the most vulnerable to problematic substance use in their reproductive years. The first 1000 days of life, starting at conception, have been established as a critical window of time for long-term health and development. Substance use in pregnancy is associated with negative pregnancy and child health outcomes. The impact of antenatal substance use on these outcomes needs to be considered within a challenging and complex context. This review provides an overview of the current literature on the impact of substances on pregnancy and child outcomes as well as the evidence and guidelines on screening and interventions for women using substances during pregnancy.

Pregnancy outcomes, early separation and psychiatric relapse experienced by South African women with peripartum psychosis: A descriptive exploration

“…found by Williams and colleagues (16) among pregnant women attending MOUs in Cape Town. The prevalence of alcohol use is cause for concern, as it contributes to the development of fetal alcohol spectrum disorders (FASD) and other long-term negative child outcomes (13). Illicit substance use was reported by 12.5% of women in this study, which exceeded the rates of 4% and 3.6% found by Vythilingum and colleagues (15) and Williams and colleagues (16), respectively.…”

“…Prenatal substance use was common (50.0%), with the use of tobacco being the most commonly used substance. Prenatal nicotine use is associated with adverse pregnancy outcomes and negatively impacts child health, behavior and development (13). The rate of smoking (40.6%) and alcohol use (21.7%) reported, were slightly higher than what Vythilingum and colleagues (15) found among women presenting for antenatal visits at a MOU in Cape Town (smoking in 36.8%, and alcohol use in 20.2% of pregnant mothers).…”

“…Substance use during pregnancy also contributes to the risk for adverse obstetric and child outcomes (13). Zhao and colleagues (14) reported that poorer birth outcomes among women with mental illness were more likely when the mother used substances during pregnancy.The high rates of substance use among South African pregnant women has been recognised by two surveys of women attending Midwife Obstetric Units in Cape Town where alcohol consumption and smoking were found to be especially prevalent (15,16).…”

<p>Perceived Risk of Weekly Cannabis Use, Past 30-Day Cannabis Use, and Frequency of Cannabis Use Among Pregnant Women in the United States</p>

“…The pervasive effects of tobacco and alcohol use during pregnancy have been widely studied, 2,46,49 however less is known regarding the effects of concomitant prenatal exposure to all these drugs. Based on our findings, as well as other previous literature [49][50][51] co-use of cannabis with other substances, occurs among pregnant women; therefore, additional screening and intervention development and implementation efforts are a priority. Typically, substance use screening and intervention are not integrated into routine prenatal care, [52][53][54][55][56][57][58] and pregnant women, who are more likely to be in need for these services, are less likely to receive them compared to non-pregnant women.…”

Antepartum Drug Dependence and Pregnancy- or Birth-related Complications: A Cross-sectional Study of 19 Million Inpatients

“…Drug dependence during pregnancy is associated with terrible outcomes. Antenatal alcohol use results in miscarriage, low birth weight, and congenital anomalies [1,2]. Cigarette smoking leads to ectopic pregnancy, increased infant mortality rate, intrauterine growth retardation, and abruptio placenta [2-4].…”