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Commentary Health and Disease

The Effect of Substances During Pregnancy

Pregnant women are told to not do multiple things, they are restricted from a lot of actions. Why is that, some may question?


Pregnant women are told to not do multiple things, they are restricted from a lot of actions. Why is that, some may question? When with a baby, everything that goes into your body has the same effect on your fetus, or your unborn baby. The adage “You are what you eat” has probably been said to you before. The same idea, however, may be extended to expectant mothers because it is their unborn children who are influenced by what is consumed. Every single thing a pregnant woman consumes, drinks, or uses is somehow passed on to her unborn child. Alcohol and hard drugs are not an exception. These drugs may cross the placenta, enter a mother’s circulation, and then reach her developing child. These toxins can also be transferred to a newborn through breast milk if a mother is nursing.

What is a Placenta? 

The placenta is an organ that grows in the uterus during pregnancy. A developing newborn receives oxygen and nutrients from this structure. It also cleans the baby’s blood of waste materials. The baby’s umbilical cord grows from the placenta, which is attached to the uterus’ wall throughout pregnancy. Typically, the organ is affixed to the uterus’s front, rear, side, or top. Rarely, the placenta may connect in the uterine cavity below. This situation is known as a low-lying placenta (placenta previa).

What are Some of the Effects the Unborn Baby Goes Through?

According to recent studies, consuming illegal drugs, prescription painkillers, tobacco or marijuana during pregnancy increases the risk of stillbirth (the death or loss of a baby before or during delivery) by a factor of two to three. About 5% of pregnant women, according to estimates, use one or more addictive substances. Neonatal Abstinence Syndrome (NAS), in which the newborn experiences withdrawal, can be brought on by the regular use of particular medicines. Opioid impacts have been the subject of the majority of this field’s research (prescription pain relievers or heroin). However, research has indicated that consuming coffee, alcohol, barbiturates, and benzodiazepines while pregnant may also result in withdrawal symptoms in the newborn. The drug(s) taken, the length of time and frequency of usage, the way the birth mother’s body processed the drug(s), and whether the child was born at full term or preterm all affect the type and intensity of the infant’s withdrawal symptoms.

Risks of Stillbirth from Substance Use in Pregnancy

Tobacco use—1.8 to 2.8 times greater risk of stillbirth, with the highest risk found among the heaviest smokers

Marijuana use—2.3 times greater risk of stillbirth

Evidence of any stimulant, marijuana, or prescription pain reliever use—2.2 times greater risk of stillbirth

Passive exposure to tobacco—2.1 times greater risk of stillbirth

Source: Tobacco, drug use in pregnancy, 2013

Opioids and pregnancy 

Opioids are a group of medications that are used to treat pain, but they also carry significant hazards, such as addiction. Opioids can be obtained legally or illegally. Doctors may recommend prescription opioids to treat moderate to severe pain. A prohibited opioid is heroin. An opioid with a prescription, fentanyl can be used to relieve really bad pain. But fentanyl has also been produced illegally, and it is now more widely available. Opioid use disorder is an opioid use habit that can lead to health issues, incapacity, or the inability to fulfill important obligations at work, school, or home. Buprenorphine, methadone, and naltrexone are examples of opioid drugs that may be used in medication aided therapy (MAT), in addition to counseling and behavioral therapy, to treat opioid use disorder. In the United States, opioid use disorder in pregnant women is a serious public health issue. According to a recent CDC investigation, the proportion of pregnant women with opioid use disorder at labor and delivery more than doubled between 1999 and 2014. Preterm birth, stillbirth, maternal death, and neonatal abstinence syndrome are just a few of the major unfavorable health outcomes associated with opioid use disorder during pregnancy for both pregnant women and unborn children (NAS). When pregnant women are exposed to opioids, a collection of withdrawal symptoms known as NAS is most frequently experienced in newborns.

Aamuktha Yalamanchili, Youth Medical Journal 2023

References

https://www.floridahealth.gov/programs-and-services/prevention/substance-abuse/substance-abuse-during-pregnancy/index.html

https://nida.nih.gov/publications/research-reports/substance-use-in-women/substance-use-while-pregnant-breastfeeding

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/substance-abuse/substance-abuse-during-pregnancy.htm

https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

https://www.cdc.gov/drugoverdose/training/pregnancy/

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Opioid-Use-and-Opioid-Use-Disorder-in-Pregnancy

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