DRUGS AND PREGNANCY
A Double Danger
When a woman becomes pregnant, it is very important for her to lead a healthy
life: to eat plenty of nourishing food, get plenty of rest, and exercise
regularly. It is also vital that she avoid anything that might harm her or her
baby-to-be. It is especially important to give up alcohol, cigarettes, and
drugs.
For a pregnant woman, drug abuse is doubly dangerous. First, drugs may harm
her own health, interfering with her ability to support the pregnancy. Second,
some drugs can directly impair prenatal development.
Which Drugs are Dangerous?
Virtually all illegal drugs, such as heroin and cocaine, pose dangers to a
pregnant woman. Legal substances, such as alcohol and tobacco, are also
dangerous, and even medical drugs, both prescription and over-the-counter, can
be harmful. For her own health and the health of her baby-to-be, a woman should
avoid all of them as much as possible, from the time she first plans to become
pregnant or learns that she is pregnant.
Drugs and the Stages of Pregnancy
Some drugs can be harmful when used at any time during pregnancy; others,
however, are particularly damaging at specific stages.
The stage of organ
formation
Most of the body organs and systems of the baby-to-be are formed within the
first ten weeks or so of pregnancy (calculated from the date of the last
menstrual period). During this stage, some drugs—and alcohol in particular—can
cause malformations of such parts of the developing fetus as the heart, the
limbs, and the facial features.
The stage of prenatal growth
After about the tenth week, the fetus should grow rapidly in weight and size.
At this stage, certain drugs may damage organs that are still developing, such
as the eyes, as well as the nervous system. Continuing drug use also increases
the risk of miscarriage and premature delivery. But the greatest danger drugs
pose at this stage is their potential to interfere with normal growth.
Intrauterine growth retardation (IUGR) is likely to result in a low-birthweight
baby—a baby born too early, too small, or both. Low-birthweight babies require
special care and run a much higher risk of severe health problems or even death.
The stage of birth
Some drugs can be especially harmful at the end of pregnancy. They may make
delivery more difficult or dangerous, or they may create health problems for the
newborn baby.
Alcohol
Alcohol is one of the most dangerous drugs for pregnant women, especially in
the early weeks. In the mother’s body, alcohol breaks down chemically to a
cell-damaging compound that is readily absorbed by the fetus. Heavy drinking
during early pregnancy greatly increases the risk of a cluster of birth defects
known as fetal alcohol syndrome. This cluster includes a small skull (microcephaly),
abnormal facial features, and heart defects, often accompanied by impeded growth
and mental retardation. Heavy drinking in later pregnancy may also impede
growth.
It is not known whether light to moderate drinking can produce these effects.
However, even if the risk is low, the stakes are very high. Medical experts
agree that a woman should avoid alcohol entirely when she decides to become
pregnant, or at least when the first signs of pregnancy appear. Even such mild
beverages as beer and wine coolers should be off limits.
Tobacco
Smoking during pregnancy appears to raise the risk of miscarriage or
premature labor. But the primary danger is hindered fetal growth. Nicotine
depresses the appetite at a time when a woman should be gaining weight, and
smoking reduces the ability of the lungs to absorb oxygen. The fetus, deprived
of sufficient nourishment and oxygen, may not grow as fast or as much as it
should.
Cocaine & Methamphetamine
Cocaine (including crack) and methamphetamine (speed, or ice) are powerful
stimulants of the central nervous system. They suppress the mother’s appetite
and exert other drastic forces on her body, causing the blood vessels to
constrict, the heart to beat faster, and the blood pressure to soar. The growth
of the fetus may be hindered, and there are higher risks of miscarriage,
premature labor, and a condition called abruptio placentae (the partial
separation of the placenta from the uterus wall, causing bleeding).
If these drugs are taken late in pregnancy, the baby may be born drug
dependent and suffer withdrawal symptoms, such as tremors, sleeplessness, muscle
spasms, and sucking difficulties. Some experts believe learning difficulties may
later develop.
Heroin & Other
Narcotics
Heavy narcotics use increases the danger of premature birth with such
accompanying problems for the infant as low birthweight, breathing difficulties,
low blood sugar (hypoglycemia), and bleeding within the head (intracranial
hemorrhage).
The babies of narcotics-dependent mothers are often born dependent themselves
and suffer withdrawal symptoms, such as irritability, vomiting and diarrhea, and
joint stiffness.
Women who inject narcotics may become infected with the HIV virus from dirty
needles and may subsequently develop AIDS. HIV-infected women obviously run a
high risk of passing the virus on to their babies.
Inhalants
At least one inhaled substance has been clearly connected with birth defects.
The organic solvent toluene, widely used in paints and glues, appears to cause
malformations like those produced by alcohol (which is itself an organic
solvent). It is possible that all organic solvents may cause birth defects.
PCP
PCP (phencyclidine, or angel dust) taken late in pregnancy can cause newborns
to have withdrawal symptoms, such as lethargy alternating with tremors.
Marijuana
Studies of marijuana use by pregnant women are inconclusive, because
marijuana is often used with other drugs, such as tobacco and alcohol. Like
them, it is associated with premature birth and low-birthweight babies.
Medications
Many medications have side effects that are potentially harmful during
pregnancy, but their benefits may outweigh their risks. A woman should consult
her doctor or midwife before taking any drug, even one sold over the counter.
Below are a few examples of medical drugs that must be used with extreme caution
or avoided altogether.
- Isotretinoin (Accutane) and etretinate (Tegison) are used to treat
chronic acne and psoriasis. They may cause chronic malformations during the
stage of organ development.
- Anticonvulsants, such as phenytoin (Dilantin) and carbamezapine (Tegretol),
are used to prevent epileptic seizures. They are associated with defects of
the heart and face, as well as mental retardation.
- Antimigraine drugs, such as ergotamine and methysergide, are used to
head off migraine attacks but raise the risk of premature labor.
- Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs)
interfere with blood clotting and increase the risk of uncontrolled bleeding
for both mother and baby. Toward the end of pregnancy, they hinder
production of the hormones that stimulate labor, so that labor may be
dangerously delayed or extended.
- Anticoagulant drugs based on coumarin are used in the treatment of heart
disease and stroke, to slow blood clotting. Taken during early pregnancy,
they are associated with facial malformations and mental retardation. Later
on they raise the risk of uncontrolled bleeding.
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