Perinatal Substance Abuse(Correct answers)
What is the prevalence of prenatal or illicit drug exposure? correct answers 400,000-440,000
(10-11% of all births)
rate with NAS (neonatal abstinence syndrome) is 3.39 per 1000 births
most likely low-income
smoking relationship with SIDS?
*quitting smoking at any point during pregnancy yields health benefits to mom and baby correct
answers increases risk - strong association
also increases risk for asthma, infantile colic, childhood obesity
What kind of medications are helpful for pregnant women to treatment drug dependence? correct
answers -methadone: has been used for 35 yrs, is associated with improved birth weight and
other improvements
-buprenorphine: has recently been shown to produce fewer NAS symptoms in infants then
methadone resulting in short infant hospital stays (suboxone in combo with naloxone) and is a
first line treatment for heroin withdrawal over methadone
What kind of behavioral treatments are helpful for pregnant women to treat drug dependence?
correct answers -contingency management: participants are given incentives (small cash
amounts, prizes, etc.) for maintaining abstinence
-motivational incentive approaches appears to increase treatment retention and prolong
abstinence
What are some direct effects of drugs on the fetus? correct answers -early in gestation, drugs can
have significant teratogenic effects
-during fetal period, after major structural development is complete, drugs have more subtle
effects, including abnormal growth and/or maturation, alterations in neurotransmitters and their
receptors, and alterations in brain organization
What are some indirect effects of drugs on the fetus? correct answers -if drugs exert a
pharmacologic effect on mom, can indirectly affect fetus.
examples: altered delivery of nutrition to the fetus (placental insufficiency or altered maternal
health behaviors attributable to addiction)
maternal factors such as decreased access to/compliance with health care, increased exposure to
violence, and increased risk of mental illness and infection may place the fetus at risk
, What are some basics on alcohol MOA on fetus? correct answers -ethanol easily crosses the
placenta into the fetus with a significant concentration of the drug identified in the amniotic fluid
as well sin the maternal and fetal blood
-ethanol has direct teratogenic effects during the embryonic and fetal stage of development as
well as:
altered neurotransmitter levels in the brain
altered brain morphology
altered neuronal development
hypoxia
What is the MOA of tobacco on fetus? correct answers -nicotine is one of 4000+compounds a
fetus is exposed to with maternal smoking. 30 of those have been associated with adverse health
outcomes
the exact MOA is unknown, it is likely that hypoxia, undernourishment of fetus, direct
vasoconstrictor effects on placental and umbilical vessels play a role in adverse fetal effects
What is the MOA of marijuana on the fetus? correct answers -placenta limits fetal exposure to
marijuana. effects of marijuana appear to be attributable to complex pharmacologic actions on
developing systems, altered uterine blood flow, and altered maternal health behaviors
-marijuana can be in body for up to 30 days, causing prolonged fetal exposure
-smoking marijuana produces 5 times the amt of carbon dioxide which may alter fetal
oxygenation
What is the MOA of opiates on the fetus? correct answers -Rapidly cross the placenta, with drug
equilibration between the mother and the fetus.
-OPiates have been shown to *decrease brain growth and cell development in animals*.
What is the MOA of cocaine on the fetus? correct answers -easily cross placenta and the blood-
brain barrier and can have significant teratogenic effects on the developing fetus
-it appears that areas of the brain that regulate attention and executive functioning are
particularly vulnerable to cocaine.
-functions such as arousal, attention, and memory may be adversely affected by prenatal cocaine
exposure.
What is the MOA of methamphetamines on the fetus? correct answers -readily passes through
the placenta and the blood-brain barrier and stimulates the CNS
-it's possible that the MOA is an interaction with and alteration of neurotransmitter systems as
well as alterations in brain morphogenesis
What are maternal characteristics that suggest a need for drug screening? correct answers -no
prenatal care
-previous unexplained fetal demise
-precipitous labor
-abruptio placentae
What is the prevalence of prenatal or illicit drug exposure? correct answers 400,000-440,000
(10-11% of all births)
rate with NAS (neonatal abstinence syndrome) is 3.39 per 1000 births
most likely low-income
smoking relationship with SIDS?
*quitting smoking at any point during pregnancy yields health benefits to mom and baby correct
answers increases risk - strong association
also increases risk for asthma, infantile colic, childhood obesity
What kind of medications are helpful for pregnant women to treatment drug dependence? correct
answers -methadone: has been used for 35 yrs, is associated with improved birth weight and
other improvements
-buprenorphine: has recently been shown to produce fewer NAS symptoms in infants then
methadone resulting in short infant hospital stays (suboxone in combo with naloxone) and is a
first line treatment for heroin withdrawal over methadone
What kind of behavioral treatments are helpful for pregnant women to treat drug dependence?
correct answers -contingency management: participants are given incentives (small cash
amounts, prizes, etc.) for maintaining abstinence
-motivational incentive approaches appears to increase treatment retention and prolong
abstinence
What are some direct effects of drugs on the fetus? correct answers -early in gestation, drugs can
have significant teratogenic effects
-during fetal period, after major structural development is complete, drugs have more subtle
effects, including abnormal growth and/or maturation, alterations in neurotransmitters and their
receptors, and alterations in brain organization
What are some indirect effects of drugs on the fetus? correct answers -if drugs exert a
pharmacologic effect on mom, can indirectly affect fetus.
examples: altered delivery of nutrition to the fetus (placental insufficiency or altered maternal
health behaviors attributable to addiction)
maternal factors such as decreased access to/compliance with health care, increased exposure to
violence, and increased risk of mental illness and infection may place the fetus at risk
, What are some basics on alcohol MOA on fetus? correct answers -ethanol easily crosses the
placenta into the fetus with a significant concentration of the drug identified in the amniotic fluid
as well sin the maternal and fetal blood
-ethanol has direct teratogenic effects during the embryonic and fetal stage of development as
well as:
altered neurotransmitter levels in the brain
altered brain morphology
altered neuronal development
hypoxia
What is the MOA of tobacco on fetus? correct answers -nicotine is one of 4000+compounds a
fetus is exposed to with maternal smoking. 30 of those have been associated with adverse health
outcomes
the exact MOA is unknown, it is likely that hypoxia, undernourishment of fetus, direct
vasoconstrictor effects on placental and umbilical vessels play a role in adverse fetal effects
What is the MOA of marijuana on the fetus? correct answers -placenta limits fetal exposure to
marijuana. effects of marijuana appear to be attributable to complex pharmacologic actions on
developing systems, altered uterine blood flow, and altered maternal health behaviors
-marijuana can be in body for up to 30 days, causing prolonged fetal exposure
-smoking marijuana produces 5 times the amt of carbon dioxide which may alter fetal
oxygenation
What is the MOA of opiates on the fetus? correct answers -Rapidly cross the placenta, with drug
equilibration between the mother and the fetus.
-OPiates have been shown to *decrease brain growth and cell development in animals*.
What is the MOA of cocaine on the fetus? correct answers -easily cross placenta and the blood-
brain barrier and can have significant teratogenic effects on the developing fetus
-it appears that areas of the brain that regulate attention and executive functioning are
particularly vulnerable to cocaine.
-functions such as arousal, attention, and memory may be adversely affected by prenatal cocaine
exposure.
What is the MOA of methamphetamines on the fetus? correct answers -readily passes through
the placenta and the blood-brain barrier and stimulates the CNS
-it's possible that the MOA is an interaction with and alteration of neurotransmitter systems as
well as alterations in brain morphogenesis
What are maternal characteristics that suggest a need for drug screening? correct answers -no
prenatal care
-previous unexplained fetal demise
-precipitous labor
-abruptio placentae
