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Effects of fetal exposure to drugs

المؤلف:  Sue Jickells , Adam Negrusz (Editors)

المصدر:  Clarkes Analytical Forensic Toxicology

الجزء والصفحة:  257

2026-10-20

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Effects of fetal exposure to drugs

Each year approximately 3–7% of neonates have birth defects and over 60% are of unknown origin. There is increasing speculation that these defects are related to exposure to drugs, alcohol, chemical agents or other xenobiotics in utero. Many drugs are thought to have significant adverse effects upon the neonate, particularly alcohol, but the majority of the illicit drug research has focused upon the effects of cocaine. In the early 1990s a US national survey found that 12 million adults used cocaine and alcohol simultaneously. Cocaine has been reported as a significant contributory factor to many adverse effects encountered in pregnancy. It is known that cocaine may affect the central dopaminergic system, and increased respiratory abnormalities of newborns can be expressed when cocaine is used during pregnancy. An increased number of cardiac problems in neonates born to cocaine using women has also been reported. Numerous other authors have demonstrated a link between cocaine use and an increase in the number of cases of placental abruption, maternal hypertension, subarachnoid and intracerebral haemorrhage, premature labour, small head size, reduced birth weight, ruptured uterus and fetal death. A significant relationship between drug use during pregnancy and an increased incidence of immune deficiency syndrome in children has also been shown. Several reports on fetal or newborn deaths were published in which maternal cocaine use was a factor. It is now well known that maternal methamfetamine abuse has similar effects upon the fetus as cocaine, including complications during pregnancy, medical complications in early neonatal life and increased rates of premature birth. Heroin related neonatal effects include opioid withdrawal symptoms such as irritability, tremors, hyperactivity and sometimes even seizures. Opiate abuse also results in the neonatal abstinence syndrome. Mental retardation and dysmorphism have been reported in neonates subjected to high doses of benzodiazepines in utero, but in these cases, alcohol may have been a confounding factor.