The Maternal, Fetal, and Neonatal Effects of Cocaine Exposure in Pregnancy

Abstract

Despite multiple efforts to reduce the use of illicit drugs, the epidemic of addiction continues to be a significant public health issue. Through its easy availability, the number of people afflicted with this addiction continues to rise, including women of childbearing age. Secondarily, any health care crisis that occurs in this age group of women will have potential implications in pregnancy, infancy, and childhood. The use of cocaine alone or in conjunction with other illicit drugs, combined with the normal physiological cardiovascular changes in pregnancy, leads to a myriad of pathophysiological changes, thereby placing the life of the pregnant cocaine user, as well as the health status of their unborn fetus and neonate at risk for adverse outcomes. As more data are available, the long-term physical, mental, and developmental sequelae for children exposed to cocaine in utero prove that this public health crisis has serious implications. The pregnancy-specific maternal, fetal, and neonatal risks of cocaine use during the antepartum period are reviewed.

Use of crack in pregnancy: repercussions for the newborn

“…The use of crack during pregnancy decreases placental uterine perfusion, impairing fetal growth, associated with significantly greater odds of preterm birth, low birth weight and smaller size for gestational age. (7) The newborn may have affected her Neurological maturation, and may present problems in learning and development of Use of crack in pregnancy: repercussions for the newborn cognitive processes, increasing the risks of difficulties in school learning, increased risk of social adjustment disorders, family and maintaining healthy affective bonds. (8) Diseases in the newborn, associated with the use of crack during pregnancy, are common.…”

Revisión narrativa. Complicaciones en la madre, feto y neonato, derivadas del consumo de cocaína durante la gestación

“…utilizada como anestésico local y vasoconstrictor en un esfuerzo para reducir la pérdida de sangre quirúrgica a finales de 1800. Las tribus indígenas usan hojas de coca durante las ceremonias religiosas para aumentar la energía, reducir la fatiga, quitar el hambre y tolerar largas jornadas de trabajo 13,14 .…”

“…Tiene metabolismo hepático, por lo que cualquier paciente con la función hepática alterada, incluidas las mujeres embarazadas, los fetos, los recién nacidos y las personas con enfermedad hepática preexistente, están en riesgo de que los efectos de la cocaína se potencien por la disminución del metabolismo. La sustancia se elimina rápidamente y varía entre 20 y 30 minutos ml/Kg/min 13 .…”

“…Además, los profesionales de la salud manifiestan que las gestantes no buscan atención prenatal ni asistencia sanitaria 13,23 .…”

“…Algunas investigaciones sugieren que diversos metabolitos de la cocaína se almacenan en las membranas de la placenta y en el miometrio, lo que implica una exposición fetal continua después del consumo 13 . Esta exposición afecta de forma potencial la maduración neuronal, con riesgo de interrupción del desarrollo del sistema nervioso central (alteración del neurodesarrollo).…”