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WHO GUIDELINES ON THE INDENTIFICATION AND MANAGEMENT OF SUBSTANCE USE IN PREGNANCY.

MEETING OF THE ALCOHOL AND OTHER DRUGS GUIDELINES DEVELOPMENT GROUP


WHO, GENEVA 11-13 September 2013

SCOPE AND PURPOSE


Consumption of tobacco, alcohol, illicit drugs and other psychoactive substances during pregnancy can lead to multiple health and social problems. Use of alcohol and other drugs during pregnancy can lead to numerous problems including: spontaneous abortion, stillbirth, low birth weight, prematurity, birth defects, intrauterine growth retardation, neonatal withdrawal symptoms and developmental problems such as fetal alcohol syndrome. Use of alcohol and other drugs can severely impair an individual's functioning in social roles such as parent, spouse or partner, and instigate and trigger gender-based and domestic violence, thus significantly affecting the development of children. Injecting drug use could also be associated with the increased risk of transmission of HIV-infection and viral hepatitis to fetus and child. WHO is developing guidelines for the identification and management of substance use and substance use disorders in pregnancy, including tobacco, alcohol and other drugs. The process began in mid-2012 as a collaborative effort between the WHO departments of Mental Health and Substance Abuse and the Tobacco Free Initiative with the development of the guidelines proposal, a virtual meeting on the Guidelines Development Group (GDG), and subsequent approval of the guidelines proposal by the WHO Guidelines Review Committee. The work on the guidelines is organized in two streams: (1) tobacco; and (2) alcohol, drugs and other psychoactive substances. The GDG for a tobacco stream met in a face-to-face meeting in Geneva in September 2012. This first meeting of the GDG stream on alcohol, drugs and other psychoactive substances will be followed by a proposed second meeting to be held in mid-2013 in Geneva. The meeting will bring together members of the GDG, representatives of partner organizations, and observers from interested organizations and institutions, to: review the proposed representation of the risks of substance use in pregnancy; examine the evidence of clinical trial research on the efficacy of different interventions which identify and manage substance use and reduce the consequences of substance use in pregnancy, as outlined in the GRADE evidence tables; examine the non clinical trial evidence of on the benefits and risks of different interventions which identify and manage substance use and reduce the consequences of substance use in pregnancy, as outlined in the GRADE evidence profiles; consider the feedback on draft recommendations; discuss good examples from around the world which respond to the problems due to substance use in pregnancy; develop recommendations on the identification and management of substance use and substance use disorders in pregnancy; and

discuss and outline the planned guidelines document(s).

The current project timeline indicates that the guidelines for the identification and management of substance use and substance use disorders in pregnancy are expected to be published in early 2014.