Neonatal Effects of Substance Abuse During Pregnancy

Background: Substance use during pregnancy can have harmful perinatal effects. Its impact depends on the drugs used. These women frequently present psychiatric comorbidities, and experience inadequate prenatal care and dysfunctional maternal-infant interactions. Depending on the drug, their children can suffer Neonatal Abstinence Syndrome (NAS) and require pharmacological treatment and extended length of hospital stay.

Objective: The aim of this study was to understand the effects of drug exposure during pregnancy on newborns.

Methods: The authors reviewed the medical records of all newborns exposed to maternal drug use (legal and illicit) during pregnancy over a 6-year period at a second level hospital.

Results: We identified 17 newborns exposed to drugs during pregnancy. Mothers had a median age of 36 years (IQR 13.5), seven (41%) had correctly monitored pregnancies, 6 (35%) had positive serologic screenings (5 HCV, 1 syphilis, 1 HIV, 1 HBV). Polysubstance use was observed in 4 women. The psychotropic substances consumed were opioids (7), cannabis (5), cocaine (4), alcohol (1). Three women were treated with benzodiazepines and could not step-down the treatment by the time of birth. Nine women confirmed tobacco consumption. Only 2 women did not present social risk factors. Of the 17 neonates, 8 were male, 3 were preterm, 11 were small for gestational age. Of the 11 neonates at risk for NAS (those exposed to opioids, benzodiazepines and alcohol), 7 (63%) experienced NAS symptoms, but only 4 (57%) met the criteria for treatment – 3 were treated with morphine and one with methadone. The duration of treatment was 40,0 ± 12,2 days ranging from 27 to 54 days.

Conclusion: The most commonly used drugs were opioids, followed by cannabis and cocaine. Most women didn’t seek proper antenatal care. Newborns whose mothers have a history of drug use are at risk and should be closely monitored.