Pregnancy and Addiction


pregnant woman holding wine glass

An individual who is pregnant as well as her child could have significant problems, and might die, due to misusing substances.1

Using inappropriate substances as well as using prescription medicines in a way that is not proper are each substance misuse.1

Of pregnant women in the age range of 15 to 44, it was estimated that in 2018:2

  • 11.6% used products containing tobacco in the last month.
  • 5.4% used illicit drugs in the last month.
  • 9.9% used alcohol in the last month.
  • 20.8% used tobacco products, illicit drugs, or alcohol in the last month.

For products containing tobacco, for illicit drugs, and for alcohol, percentages estimated for 2018 for last month use were lower in the second trimester than the first and lower in the third trimester than the second.2

Possible Impacts

An unborn baby might receive toxins from the mother.3

Consequences for a baby whose mother used alcohol and/or other drugs while pregnant might include:3,4

  • Being born early
  • Low weight when born
  • Dependence on substance(s)
  • Birth defects
  • Sudden infant death syndrome (SIDS)
  • Issues with feeding
  • Issues with development

A woman who is pregnant and misuses substances might postpone prenatal care or might not seek it at all because she is afraid she would be punished for her substance use.5

For a woman who is pregnant and misuses substances, some possible barriers to prenatal care include being discriminated against, being stigmatized, and being afraid of being punished.5

A woman might be arrested and prosecuted if she uses substances while pregnant.5

Fetal Alcohol Spectrum Disorders

If a woman consumes alcohol while she is pregnant, her child might have a fetal alcohol spectrum disorder (FASD).6

FASDs can impact individuals differently; impacts may include:6

  • Short stature
  • Features of the face being different from normal
  • Low weight
  • Small head
  • Kidney, heart, and/or bone issues
  • Issues with seeing and/or hearing
  • Trouble concentrating
  • Intellectual and/or learning disabilities
  • Hyperactivity
  • Worse memory
  • Worse coordination

Neonatal Abstinence Syndrome

A collection of withdrawal signs called neonatal abstinence syndrome (NAS) could affect a baby after birth if the baby’s mother used opioids (e.g., heroin, buprenorphine, and/or codeine) while she was pregnant with the baby.4,7

NAS might also affect a newborn whose mother used other illicit drugs, other prescription drugs, alcohol, and/or tobacco.4,7

When a person who is pregnant uses a substance, it might go through the placenta and the fetus might become dependent on that substance.3,4 When the child is born and is not receiving the substance anymore, withdrawal signs might appear.4,7

A baby with NAS might have symptoms including:4

  • Sweating
  • Skin that is blotchy
  • Fever
  • Having seizures
  • Being irritable
  • Shaking
  • Sneezing
  • Issues with sleep
  • Diarrhea
  • Hyperactive reflexes
  • Not feeding adequately
  • Nasal congestion
  • Throwing up
  • Breathing quickly

Weeks or even months in a hospital might be necessary for an infant with NAS.4

A baby with NAS might receive a medication that is similar to the substance the baby was exposed to before birth, with the dose of the medication being gradually reduced.4

Littler, more frequent feedings and/or feedings containing more calories might be necessary for infants who are growing slowly or having feeding issues; intravenous fluids might be necessary for dehydrated infants or infants who throw up.4

Some Other Possible Impacts by Drug

If a woman misuses opioids when she is pregnant, possible repercussions for her unborn child include fetal convulsions, growth being inhibited, and death before birth; furthermore, she may go into labor early and/or her newborn may have NAS.4,8

If a woman misuses methamphetamine when she is pregnant, there might be a higher likelihood of problems including placental abruption, her baby being born early, her baby having brain and/or heart anomalies, and her baby being small.9

If a woman uses cocaine when she is pregnant, issues that might result from that include miscarriage, hypertensive crisis, and early labor; additionally, the baby’s head might be small and weight might be low when born.10

There is a connection between smoking when pregnant and several issues, such as early birth, issues with the placenta, low weight when born, raised miscarriage risk, and raised stillbirth risk.11

*Note: This is not a complete list of all substances that could impact an unborn baby and/or pregnant woman, and this is not a complete list of all possible impacts of those substances which are listed. Do not assume any substance is safe during pregnancy, talk to a healthcare provider.

Stopping Substances

There ought to be medical oversight as well as monitoring if someone who is pregnant goes through withdrawal from alcohol or another addictive drug; detoxing is risky for the unborn baby, and withdrawal could be deadly.12

It is not advised for women who have opioid use disorder and are pregnant to go through medically supervised withdrawal.7 For individuals who are pregnant, treatments advised for opioid use disorder include methadone and buprenorphine, which have been demonstrated to be efficacious as well as safe.7,8

Discuss any misuse of substances with a healthcare provider.1

 

Sources:
  1. National Center on Early Childhood Health and Wellness. What to know before you go: Substance misuse among pregnant women.
  2. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables.
  3. A.D.A.M., Inc. (2017). Infant of a substance using mother. In A.D.A.M. Medical Encyclopedia.
  4. A.D.A.M., Inc. (2017). Neonatal abstinence syndrome. In A.D.A.M. Medical Encyclopedia.
  5. Stone, R. (2015). Pregnant women and substance use: fear, stigma, and barriers to careHealth & Justice, 3.
  6. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. (2019). Basics about FASDs.
  7. Substance Abuse and Mental Health Services Administration. (2018). Clinical guidance for treating pregnant and parenting women with opioid use disorder and their infants.
  8. National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. (2017). Treating opioid use disorder during pregnancy.
  9. National Institute on Drug Abuse. (2019). Methamphetamine: What are the risks of methamphetamine misuse during pregnancy?.
  10. National Institute on Drug Abuse. (2016). Cocaine: What are the effects of maternal cocaine use?.
  11. National Institute on Drug Abuse. (2019). Tobacco, nicotine, and e-cigarettes: What are the risks of smoking during pregnancy?.
  12. Center for Substance Abuse Treatment. (2009). Substance abuse treatment: Addressing the specific needs of women.


About The Contributor

Sophie Stein, MSN
Sophie Stein, MSN

Clinical Editor

Sophie Stein received her master’s of science in nursing from Vanderbilt University School of Nursing. She previously worked as an advanced practice registered nurse at an outpatient psychiatric practice providing mental health care for children,... Read More


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