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Malformation of Malformation of ExtremitiesExtremities
Child with Child with Meningomyelocele Meningomyelocele at thoracic spineat thoracic spine
Twins with Twins with deformities of deformities of faces, clip lips faces, clip lips and palatesand palates
Spina bifida has been Spina bifida has been linked to linked to antidepressants. antidepressants.
Pregnancy with DrugsPregnancy with Drugs
More than More than 90%90% of pregnant women of pregnant women take prescription or nonprescription (over-take prescription or nonprescription (over-the-counter) drugs or use social drugs, the-counter) drugs or use social drugs, such as tobacco and alcohol, or illicit such as tobacco and alcohol, or illicit drugs at some time during pregnancy. In drugs at some time during pregnancy. In general, drugs, unless absolutely general, drugs, unless absolutely necessary, should not be used during necessary, should not be used during pregnancy, because many can harm the pregnancy, because many can harm the fetus. About fetus. About 2 to 3%2 to 3% of all birth defects of all birth defects result from the use of drugs.result from the use of drugs.
Drugs taken by a pregnant woman reach the Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the same fetus primarily by crossing the placenta, the same route taken by oxygen and nutrients, which are route taken by oxygen and nutrients, which are needed for the fetus's growth and development. needed for the fetus's growth and development. Drugs can affect the fetus in several ways:Drugs can affect the fetus in several ways:
•act directly on the fetus, causing damage, act directly on the fetus, causing damage, abnormal development (leading to birth defects), abnormal development (leading to birth defects), or death. or death.
• alter the function of the placenta, usually alter the function of the placenta, usually by reducing the supply of oxygen and nutrients to by reducing the supply of oxygen and nutrients to the fetus thus resulting in an underweight and the fetus thus resulting in an underweight and underdeveloped baby. underdeveloped baby.
•cause the muscles of the uterus to contract cause the muscles of the uterus to contract forcefully, thus injuring the fetus by reducing its forcefully, thus injuring the fetus by reducing its blood supply or triggering preterm labor and blood supply or triggering preterm labor and delivery. delivery.
How Drugs Cross the PlacentaHow Drugs Cross the Placenta
Key PointsKey Points
• No OTC (over-the-No OTC (over-the-counter) drugs should counter) drugs should be taken without be taken without doctor’s permission.doctor’s permission.
• The drug addiction The drug addiction can be passed on to can be passed on to baby and baby must baby and baby must go through painful go through painful withdrawal period withdrawal period after birthafter birth
•Caffeine:Caffeine: harms the fetus is harms the fetus is unclear. It is a stimulant that readily unclear. It is a stimulant that readily crosses the placenta to the fetus. Thus, crosses the placenta to the fetus. Thus, it may stimulate the fetus, it may stimulate the fetus, increasing increasing the heart and breathing ratesthe heart and breathing rates. Caffeine . Caffeine also may decrease blood flow across also may decrease blood flow across the placenta and decreases the the placenta and decreases the absorption of iron (possibly increasing absorption of iron (possibly increasing the risk of anemia).the risk of anemia).
Drinking 7-8 cups or more/day Drinking 7-8 cups or more/day increases the risk of having a stillbirth, increases the risk of having a stillbirth, premature birthpremature birth, l, low-birth-weightow-birth-weight baby, or baby, or miscarriagemiscarriage is also unclear. is also unclear.
• Cocaine:Cocaine: Cocaine readily crosses the placenta Cocaine readily crosses the placenta and affects the fetus. It constricts blood vessels, and affects the fetus. It constricts blood vessels, reducing blood flow (and the oxygen supply) to reducing blood flow (and the oxygen supply) to the fetus, particularly of the bones and the the fetus, particularly of the bones and the intestine. Rarely, use of cocaine results in birth intestine. Rarely, use of cocaine results in birth defects of the defects of the brainbrain, , eyeseyes, , kidneyskidneys, and , and genital genital organsorgans. .
• Use of cocaine during pregnancy can also cause Use of cocaine during pregnancy can also cause complications during pregnancy, about complications during pregnancy, about 31% have 31% have a preterm deliverya preterm delivery and and 15% have premature 15% have premature detachment of the placentadetachment of the placenta (placental abruption). (placental abruption).
• Newborns may have Newborns may have withdrawal symptomswithdrawal symptoms. Their . Their behavior is also behavior is also affectedaffected. Newborns interact less . Newborns interact less with other people. with other people. Babies of cocaine users may be Babies of cocaine users may be hyperactive, tremble uncontrollably, and have hyperactive, tremble uncontrollably, and have difficulty learning (which may continue through difficulty learning (which may continue through age 5 years or even longer).age 5 years or even longer).
•Opioids:Opioids: such as heroin, methadone, such as heroin, methadone, and morphine, readily cross the and morphine, readily cross the placenta. Consequently, the fetus may placenta. Consequently, the fetus may become addicted to them and may become addicted to them and may have withdrawal symptoms 6 hours to 8 have withdrawal symptoms 6 hours to 8 days after birth. However, use of days after birth. However, use of opioids rarely results in birth defects opioids rarely results in birth defects and increases the risk of complications, and increases the risk of complications, such as such as miscarriagemiscarriage, , abnormal abnormal presentationpresentation of the baby, and of the baby, and congenital heart problemscongenital heart problems. Babies of . Babies of heroin users are more likely to be small.heroin users are more likely to be small.
•Amphetamines:Amphetamines: Use of Use of amphetamines during pregnancy amphetamines during pregnancy may result in may result in birth defectsbirth defects, especially , especially of the of the heartheart..
•Marijuana:Marijuana: harm the fetus is harm the fetus is unclear. The main ingredient of unclear. The main ingredient of marijuana, tetrahydrocannabinol, can marijuana, tetrahydrocannabinol, can cross the placenta and thus may cross the placenta and thus may affect the fetus. If marijuana is used affect the fetus. If marijuana is used heavily during pregnancy, newborns heavily during pregnancy, newborns may have may have behavioral problemsbehavioral problems..
ConclusionConclusion• Try to avoid any kind of drugs before, during, and Try to avoid any kind of drugs before, during, and
after pregnancyafter pregnancy• If necessarily use, under the prescription and If necessarily use, under the prescription and
strictly follow doctor’s directionstrictly follow doctor’s direction• No self-medicationNo self-medication• Provide sufficient and healthy foodProvide sufficient and healthy food• Follow up doctor’s appointmentFollow up doctor’s appointment• The best choice of addictive pregnancy, consult The best choice of addictive pregnancy, consult
your doctor, counseling center, AA, NA, and other your doctor, counseling center, AA, NA, and other servicesservices
• Participate with every teaching classesParticipate with every teaching classes• Enjoy life, have fun, and prepare for a new Enjoy life, have fun, and prepare for a new
membermember
ReferencesReferences• Drug use during pregnancy, The MERCK manual of Drug use during pregnancy, The MERCK manual of
medical information-second home edition, online medical information-second home edition, online version, http://www.merck.com/mmhe/index.htmlversion, http://www.merck.com/mmhe/index.html
• Teenage pregnancy and drug abuse,Teenage pregnancy and drug abuse,
• Illicit drug use in pregnancy, Illicit drug use in pregnancy, http://www.marchofdimes.com/professionals/14332_1http://www.marchofdimes.com/professionals/14332_1169.as/169.as/
• Drug abuse and treatment, National Women's Health Drug abuse and treatment, National Women's Health Information Center, http://www.4woman.gov/Information Center, http://www.4woman.gov/
• Alcohol research group, National research center, Alcohol research group, National research center, Public Heath Institute, Public Heath Institute, http://www.arg.org/studies.htmlhttp://www.arg.org/studies.html
Thank YouThank You
