Drug Use in Pregnancy: Mother and Child

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Presentation transcript:

Drug Use in Pregnancy: Mother and Child Ira J. Chasnoff, MD irachasnoff@gmail.com

Children grow and develop in the context of… Relationships (C) NTI Upstream, 2018

Attachment: Basic Concept Attachment is… the interconnectedness between human beings. Attachment requires… reading each other’s cues responding appropriately to each other’s cues. Mother Child (C) NTI Upstream, 2018

Attachment: Where to Start? Mother Child (C) NTI Upstream, 2018

When does risk happen? Embryonic Fetal Newborn Infant Toddler Conception Newborn Infant Toddler Preschool Early childhood Primary grades Middle School Adolescence Childhood (C) NTI Upstream, 2018

Embryonic Period Embryonic Early gestational stress marks the genes First 12 weeks after conception Cells are “undedicated” (stem cells) Cells become imprinted during this phase Early gestational stress marks the genes Adds a methyl group to the gene (methylation) Becomes fixed as memory: epigenetic memory (C) NTI Upstream, 2018

Fetal memory (C) NTI Upstream, 2018

Attachment: Where to Start? Mother Child (C) NTI Upstream, 2018

Two Essential Caregiver Qualities Accessibility Responsiveness (C) NTI Upstream, 2018

Six Factors Affecting Relationships in Chemically Dependent Women Negative heritage Trauma history Lack of social support (C) NTI Upstream, 2018

Six Factors Affecting Relationships in Chemically Dependent Women Negative heritage Emotional instability Lack of social support Cognitive functioning (C) NTI Upstream, 2018

Six Factors Affecting Relationships in Chemically Dependent Women Negative heritage Trauma history Lack of social support Cognitive functioning Psychological functioning (C) NTI Upstream, 2018

Six Factors Affecting Relationships in Chemically Dependent Women Negative heritage Emotional instability Lack of social support Cognitive functioning Psychological functioning Substance abuse (C) NTI Upstream, 2018

* Strathearn, et al. Neuropsychopharmacology, 2009 (C) NTI Upstream, 2018 Strathearn, et al. Neuropsychopharmacology, 2009

* Strathearn, et al. Neuropsychopharmacology, 2009 (C) NTI Upstream, 2018 Strathearn, et al. Neuropsychopharmacology, 2009

Chronic administration of drugs of abuse, such as cocaine, substantially reduces oxytocin levels in the hypothalamus. (C) NTI Upstream, 2018

Ox * Substance abuse Strathearn, et al. Neuropsychopharmacology, 2009 Oxytocin Substance abuse (C) NTI Upstream, 2018 Strathearn, et al. Neuropsychopharmacology, 2009

Just in case you didn’t get it… Relationships (C) NTI Upstream, 2018

Biological Basis of the Effects of Prenatal Drug Use: The Catecholamine System (C) NTI Upstream, 2018

Biological Basis of the Effects of Prenatal Drug Use: Methamphetamines Catecholamines (C) NTI Upstream, 2018

Biological Basis of the Effects of Prenatal Drug Use: Cocaine Catecholamines Cocaine (C) NTI Upstream, 2018

Neonatal Complications SIDS Dysmorphology Prematurity Low birth weight Failure to thrive (C) NTI Upstream, 2018

Neonatal Complications SIDS Dysmorphology CNS damage Low birth weight Prematurity Failure to thrive (C) NTI Upstream, 2018

Neonatal Complications SIDS Dysmorphology CNS damage NAS Low birth weight Prematurity Failure to thrive (C) NTI Upstream, 2018

Attachment: The Infant’s Readiness for Attachment Mother Child (C) NTI Upstream, 2018

Two Essential Infant Qualities Accessibility Responsiveness (C) NTI Upstream, 2018

Newborn Neurobehavior Orientation State regulation (C) NTI Upstream, 2018

Information Processing Model Four domains of information processing Input (recording information) Integration (interpreting input) Memory (storing input for later use) Output (appropriate use of language and motor skills) (C) NTI Upstream, 2018

(C) NTI Upstream, 2018

(C) NTI Upstream, 2018

(C) NTI Upstream, 2018

Biological Basis of the Effects of Prenatal Drug Use: The Catecholamine System (C) NTI Upstream, 2018

Biological Basis of the Effects of Prenatal Drug Use: Methamphetamines Catecholamines (C) NTI Upstream, 2018

Biological Basis of the Effects of Prenatal Drug Use: Cocaine Catecholamines Cocaine (C) NTI Upstream, 2018

ntiupstream.com (C) NTI Upstream, 2018