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A 2008-2009 Study
Placental Membrane
The placenta of pregnant women acts as a filter to the baby, and not a barrier as once believed. Virtually all drugs pass through the placenta and into the fetus. The placenta mediates substances from mother to child and vice versa.
Caffeine
Coffee, tea, cola, chocolate, cold remedies over the counter (otc) pills
Caffeine
Maternal Effects CNS and cardiac function stimulation Vasoconstriction and mild diuresis result Half-life triples during pregnancy Fetal Effects Placental barrier is crossed, stimulating fetus Teratogenic effects are undocumented
Nicotine
Smoking during pregnancy is associated with adverse effects for the fetus, newborn, and mother.
According to NIH Carbon monoxide and nicotine from tobacco smoke may interfere with fetal oxygen supply and because nicotine readily crosses the placenta, it can reach concentrations in the fetus that are much higher than maternal levels. Nicotine concentrates in fetal blood, amniotic fluid, and breast milk, exposing both fetuses and infants to toxic effects (NIH, 2011).
Tobacco
Maternal Effects Decreased placental perfusion Anemia PROM< preterm labor, spontaneous abortion Fetal/Neonatal Effects Prematurely LBW Fetal demise Developmental delays Increased incidence of SIDS Pneumonia
Alcohol
Alcohol (beer, wine, mixed drinks, afterdinner drinks)
Alcohol
Maternal Effects Spontaneous abortion Fetal/Neonatal Effects Fetal demise IUGR, FAS (Facial and cranial anomalies developmental delay, mental retardation, short attention span), Fetal alcohol effects (milder form of FAS fetal alcohol syndrome)
Narcotics
Narcotics (heroin, methadone, morphine)
Narcotics
Maternal Effects Spontaneous abortion PROM, preterm labor, Increased incidence of STDs Increase HIV exposure Hepatitis Malnutrition Effects on Fetus IUGR Perinatal asphyixia Intellectual impairment Neonatal abstinence syndrome Neonatal infections Neonatal death (SIDS, child abuse and neglect)
Sedatives
Barbiturates, tranquilizers, anti-anxiety
Sedatives
Maternal Effects Lethargy Drowsiness CNS depression Fetal Effects Neonatal abstinence syndrome Seizures Delayed lung maturity Possible teratogenic effects
Cocaine
Cocaine and crack
Amphetamines
Amphetamines ( Speed or ice when processed in crystals to smoke) Methamphetamines ( ecstasy)
Amphetamines
Maternal Effects Malnutrition Tachycardia Withdrawal symptoms ( lethargy, depression) Fetal/Neonatal Effects Increased risk for cardiac anomalies Increase for cleft palate IUGR Withdrawal symptoms Fetal death
Marijuana
Marijuana (pot or grass)
Marijuana
Maternal Effects Often used with other drugs: alcohol, cocaine, tobacco Increased incidence of anemia Inadequate weight gain Fetal/Neonatal Effects Unclear, more study needed Believed to be related to prematurity IUGR Neonatal tremors Sensitivity to light.
Treatment
Treating substance abuse during pregnancy should begin as soon as the mother learns that she is pregnant.
Women who plan of becoming pregnant should talk to their doctors regarding prepregnancy health including the use of substances and addictions they may have.
Treatment
If a woman who uses substances such as tobacco, nicotine, caffeine, alcohol, or drugs and becomes pregnant unintentionally should immediately contact their doctor to develop a treatment plan for both the mother and developing embryo/fetus/neonatal.
Treatment
Treatment always includes a prenatal regimen of prenatal vitamins and nutritional diet to support both mother and baby. Regular doctors visits Regular exercise (per doctors orders) Adequate sleep Stress reduction Education on pregnancy and health
If the mother is a substance abuser, an individual treatment plan should be designed by her doctor.
References
DRUGS IN PREGNANCY: Effects on the Fetus and Newborn http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1575893/ Murray, S.S., McKinney, E.S., Gorrie, T., M., (2002) Foundations of Maternal Newborn Nursing (3rd Ed). St. Louis. W.B. Saunders Co.