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Malformation of Extremities
Twins with deformities
of faces, clip lips
and palates
Child with
Meningomyelocele at
thoracic spine
Spina bifida has been
linked to
antidepressants.
Pregnancy
with
Drugs
Kris Trairatana
[email protected]
Pregnancy with Drugs
More than 90% of pregnant women take
prescription or nonprescription (over-thecounter) drugs or use social drugs, such as
tobacco and alcohol, or illicit drugs at some
time during pregnancy. In general, drugs,
unless absolutely necessary, should not be used
during pregnancy, because many can harm the
fetus. About 2 to 3% of all birth defects result
from the use of drugs.
Drugs taken by a pregnant woman reach the fetus
primarily by crossing the placenta, the same route taken
by oxygen and nutrients, which are needed for the
fetus's growth and development. Drugs can affect the
fetus in several ways:
• act directly on the fetus, causing damage, abnormal
development (leading to birth defects), or death.
•
alter the function of the placenta, usually by
reducing the supply of oxygen and nutrients to the fetus
thus resulting in an underweight and underdeveloped
baby.
• cause the muscles of the uterus to contract
forcefully, thus injuring the fetus by reducing its blood
supply or triggering preterm labor and delivery.
How Drugs Cross the Placenta
Key Points
• No OTC (over-the-
•
counter) drugs should
be taken without
doctor’s permission.
The drug addiction
can be passed on to
baby and baby must
go through painful
withdrawal period
after birth
• Caffeine: harms the fetus is unclear. It
is a stimulant that readily crosses the
placenta to the fetus. Thus, it may
stimulate the fetus, increasing the heart
and breathing rates. Caffeine also may
decrease blood flow across the placenta
and decreases the absorption of iron
(possibly increasing the risk of anemia).
Drinking 7-8 cups or more/day
increases the risk of having a stillbirth,
premature birth, low-birth-weight baby, or
miscarriage is also unclear.
• Cocaine: Cocaine readily crosses the placenta and
•
•
affects the fetus. It constricts blood vessels, reducing
blood flow (and the oxygen supply) to the fetus,
particularly of the bones and the intestine. Rarely, use of
cocaine results in birth defects of the brain, eyes,
kidneys, and genital organs.
Use of cocaine during pregnancy can also cause
complications during pregnancy, about 31% have a
preterm delivery and 15% have premature detachment
of the placenta (placental abruption).
Newborns may have withdrawal symptoms. Their
behavior is also affected. Newborns interact less with
other people. Babies of cocaine users may be
hyperactive, tremble uncontrollably, and have difficulty
learning (which may continue through age 5 years or
even longer).
• Opioids: such as heroin, methadone,
and morphine, readily cross the placenta.
Consequently, the fetus may become
addicted to them and may have
withdrawal symptoms 6 hours to 8 days
after birth. However, use of opioids rarely
results in birth defects and increases the
risk of complications, such as miscarriage,
abnormal presentation of the baby, and
congenital heart problems. Babies of
heroin users are more likely to be small.
• Amphetamines: Use of amphetamines
during pregnancy may result in birth
defects, especially of the heart.
• Marijuana: harm the fetus is unclear.
The main ingredient of marijuana,
tetrahydrocannabinol, can cross the
placenta and thus may affect the fetus. If
marijuana is used heavily during
pregnancy, newborns may have
behavioral problems.
Conclusion
• Try to avoid any kind of drugs before, during, and after
•
•
•
•
•
•
•
pregnancy
If necessarily use, under the prescription and strictly
follow doctor’s direction
No self-medication
Provide sufficient and healthy food
Follow up doctor’s appointment
The best choice of addictive pregnancy, consult your
doctor, counseling center, AA, NA, and other services
Participate with every teaching classes
Enjoy life, have fun, and prepare for a new member
References
• Drug use during pregnancy, The MERCK manual of
medical information-second home edition, online version,
http://www.merck.com/mmhe/index.html
• Teenage pregnancy and drug abuse,
• Illicit drug use in pregnancy,
http://www.marchofdimes.com/professionals/14332_116
9.as/
• Drug abuse and treatment, National Women's Health
Information Center, http://www.4woman.gov/
• Alcohol research group, National research center, Public
Heath Institute, http://www.arg.org/studies.html
Thank You