Summary Substance Misuse in Pregnancy

Substance Misuse in Pregnancy

Alcohol  Risk of anomalies related to the extent of alcohol use:
- 10% with rare use
- 15% with moderate use
- 30-40% with heavy use (>6 units a day)
Foetal Effects:
 Foetal alcohol syndrome
- Mid-facial hypoplasia
- Microcephaly
- Learning difcultes
- IUGR
 Renal defects
 Cardiac defects
 Neonatal abstnence syndrome (NAS)
Cigarete  20-30% of smoking women contnue to smoke during pregnancy
Smoking  Smoking decreases fertlity
Foetal effects:
 Spontaneous aborton
 Preterm birth
 Perinatal mortality
 IUGR (200g decrease in birth weight for every 10 cigaretes smoked per day)
Marijuana Foetal effects:
 No known teratogenic efect
 Associaton with:
- Preterm birth
- IUGR
- Neurodevelopmental delay
Cocaine Foetal effects:
 IUGR
 Cerebral infarcton
 Placental abrupton
 Congenital anomalies (due to cocaine-induced vasospasm) e.g.
- Microcephaly
- Limb reducton defects
- Porencephalic (brain) cysts
- Bowel atresia
- Necrotsing enterocolits
- Long-term behavioural defects
Maternal effects:
 Uterine rupture
 HTN
 Seizures
 Death

Antenatal Management for Addicton
SMOKING
 All women should be advised to stop smoking or given help to cut down, preferably before they conceive
 NRT can be prescribed by her GP (NOTE: Do NOT prescribe Bupropion if pregnant or breasteeding)

ALCOHOL
 Clear advice to cut down her alcohol consumpton
 Educated about the increased risks associated with drinking in pregnancy
 Self-help booklet ‘So you want to cut down your drinking?’ (HEBS 1998)