1. Drug Abuse and Pregnancy
Rahmat Na’Allah, MD MPH
Resurrection West Suburban Medical Center, Oak Park IL
Northwestern University, Department of Family Medicine, Chicago IL
PCC Community Wellness Center, Oak Park IL
Marjorie Altergott, PhD
Harry Piotrowski, MS

2. Epidemiology Substance abuse is on the increase worldwide(1)
In the US, nearly 90% of drug abusing women are of reproductive age(1)
Many are Polysubstance Abusers(1)
Risk Factors include: no prenatal care, cigarette smoking, history of preterm labor(1)

3. Epidemiology (contd.) (2)
2.8% national average of drug use in pregnancy
Marijuana accounted for about 75%
Cocaine use was 10%
Young, unmarried, low education level had higher drug use
Married, higher education, insured had higher alcohol use

4. Effect of Cocaine on Pregnancy (3)
Spontaneous Abortion
Abruptio Placentae
Premature/Precipitous Labor
Still Birth
Neonatal Abstinence Syndrome (NAS)
Neurodevelopmental Abnormalities

5. Effect of Heroin on Pregnancy (4)
Low Birth Weight (LBW)
Miscarriage
Prematurity
Microcephaly
Intrauterine Growth Retardation

6. Effect Of Marijuana on Pregnancy (3)
Memory and Verbal Delay at 48 months
Premature Birth and LBW (6)
Inattention, Impulsivity and Poor Academic Performance

7. Characteristics of Substance Abusing Pregnant Women (5)
More likely to be raised by substance abusers
Problematic Relationships
Early Sexual Abuse
Domestic Violence
Spousal drug abuse
Psychiatric Disorders

8. Current Trend and Recommendations
Per ACOG: All pregnant women should be questioned about previous and current drug use (7)
Prevention of drug use should be an important part of public health program for young women
The burden of drug use calls for policy changes to enable primary care providers to identify and refer women for help

9. References
1. Kuczkowski KM. The effects of drug abuse on pregnancy. Curr Opin Obstet Gynecol 2007;19(6):
2. Ebrahim SH, Gfroerer J. Pregnancy-related substance use in the United States during Obstet Gynecol 2003;101(2):374-9.
3. Bennett AD. Perinatal substance abuse and the drug-exposed neonate. Adv Nurse Pract 1999; 7(5):32-6.

10. References (contd.)
4. Leech SL, et al. Prenatal substance exposure: Effects on attention and impulsivity of 6-year-olds. Neurotoxicol Teratol 1999;21(2):
5. Hans SL. Demographic and psychosocial characteristics of substance-abusing pregnant women. Clin Perinatol 1999;26(1):55-74.

11. References (contd.)
6. Fried PA, et al. Marijuana use during pregnancy and decreased length of gestation. Am J Obstet Gynecol 1984;150:23-27.
7. Substance abuse in pregnancy. ACOG Technical Bulletin Number 195--July 1994 (replaces No. 96, September 1986). Int J Gynaecol Obstet 1994;47(1):73-80.