Cocaine use in pregnancy
If I am abusing cocaine in pregnancy, what are the likely adverse effects to the fetus?
The fetus of a cocaine-abusing mother is in peril throughout the course of the pregnancy. The miscarriage rate among cocaine abusers is more than double that of non-abusers.
For those fetuses who survive to the second half of the pregnancy, a substantial proportion will be found to be growth restricted and many are born prematurely.
At least one in twenty (5%) will be stillborn, a far higher rate than in non-users.
The rate of placental abruption (premature separation of the afterbirth) is also high and most of the affected babies die. In fact, this complication is life-threatening to the mother as well.
Any mother using cocaine in pregnancy should remember these five complications, since she is a prime candidate: Miscarriage, growth restriction, prematurity, stillbirth and placental abruption.
It is a pretty dire picture; what is one to do?
The only way to avoid these problems is to stop abusing the drug. This may be difficult but there is really no alternative.
If I manage to scrape through and deliver a healthy baby, am I in the clear?
First of all, your baby may have various forms of major malformation as a direct consequence of being exposed to the drug in the womb.
Secondly, the baby will suffer severe withdrawal symptoms requiring hospitalization.
Thirdly, and more ominous, is that the baby is at great risk of cot death. The rate of cot death (SIDS) among cocaine-abusing mothers is increased more than thirty-fold compared to the general population.
Should I breast-feed if I am still using cocaine?
Don't even consider it. Cocaine appears in breast-milk in significant quantities and its effects on the baby could be catastrophic.
Is a baby born to a cocaine-abusing mother at risk of anything other than the mentioned cot death?
The baby may have abnormalities of the visual system. Haemorrhages of the retina in the eyes are rather common and the effects could be long-lasting.
There is evidence also that children exposed to cocaine in the uterus are more likely to suffer from attention-deficit disorders when compared to the general population.
Cannabis use in pregnancy
What about use of cannabis (marijuana) in pregnancy?
There are, without doubt, a number of people who would baulk at the term "abuse" in reference to cannabis use. We will not attempt here to argue the merits of this debate one way or the other. But, when it comes to pregnancy, cannabis use is undoubtedly a bad idea. Many of the adverse effects of cigarette smoking can be encountered with cannabis use.
Of course, research on this has repeatedly been frustrated by the fact that many - if not most - of those who use cannabis are cigarette smokers as well.
What is known for sure is that cannabis use independently causes intrauterine growth restriction (IUGR) with all the potential problems associated with this.
Cannabis may also cause fetal malformations, with sporadic reports of babies born with dysmorphic features where cannabis appears to be the only identifiable potential culprit. However, there is, to date, no solid evidence to conclusively state that cannabis is teratogenic (a cause of congenital defects).
The baby may display behavioural and sleep abnormalities, especially in the first few weeks.
With cannabis use in pregnancy, there may be delay in cognitive development for the child.
When a woman using cannabis becomes pregnant, she should be encouraged to give up. This is safe to do during pregnancy. Most, if not all, hospitals have got rehabilitation units where individuals with a problem of substance abuse are helped by professionals to give up.
Last Update: January 31, 2013