Harmful Effects of Drug Abuse During Pregnancy

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Increasing numbers of women are abusing drugs during pregnancy and thus endangering the well-being and lives of their children as well as themselves. The spreading abuse of phencyclidine (PCP), cocaine, and cocaine's potent form "crack," added to the more well-known addictive narcotics such as heroin, has intensified concerns about the implications of maternal drug use for unborn children.

Some harmful effects are generally recognized. Cocaine use, for example, increases risk of hemorrhage and premature delivery, threatening the lives of mother and child. Babies exposed to narcotics in the womb are frequently born addicted, and the misery they suffer from withdrawal makes them difficult to care for, creating special demands on mothers who are often unable to take care of their children adequately. Other effects are less certain.

Head size is often smaller in infants exposed to narcotics. While growth erases some of the physical differences, there may be subtle, long-term deficits in mental or neurological functioning in infants exposed to drugs in the womb. Scientists are just beginning to explore how various drugs may affect the development of physical coordination, language, and emotional interactions.

NIDA, through its clinical, epidemiological, and basic research programs, is increasing knowledge of immediate and long-term effects of drug use during pregnancy. NIDA grantees and others are designing and evaluating therapeutic programs to help mothers and their children overcome the harm caused by drugs.

Scope of the Problem

Evidence of increasing drug use among pregnant women comes from many parts of the country. NIDA estimates that of the women of childbearing age (15 to 44 years), 15 percent are current subs...

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...that cocaine-addicted women were twice as likely to suffer premature separation of the placenta as women dependent on other drugs and four times as likely as drug-free women to experience this complication. However, this risk is reduced if the pregnant woman discontinues cocaine use early in pregnancy.

Isolated cases of birth defects have been associated with cocaine use during pregnancy; however, additional studies are needed to confirm these observations. Cocaine also can precipitate miscarriage or premature delivery because it raises blood pressure and increases contractions of the uterus. Maternal cocaine use also endangers the fetus directly. Studies show that the drug constricts arteries leading to the womb. This constriction diminishes the amount of blood, and hence oxygen, that reaches the fetus. In one extreme case, cocaine apparently caused fetal stroke.

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