L8 - SUBSTANCE USE DURING PREGNANCY Flashcards
List 4 risk factors for substance use during pregnancy.
-Family history of substance use
-Encounters with law enforcement
-History of sexual abuse
-Psychiatric illness
Through what organ are the drugs transferred to the fetus?
The placenta.
List 4 functions of the placenta.
- Providing oxygen and nutrients (drugs take the same passage)
- Removal of harmful waste products
- Produces hormones
- Pass immunity
What are the two variables determining on which depends drug transfer into the placenta?
-Physical properties of the placenta
-Specific physiochemical properties of the drug
List 7 placental properties.
-Placenta surface area
-Placenta thickness
-pH of maternal and fetal blood
-Placenta metabolism
-Uteroplacental blood flow
-Presence of placental drug transporters
-Concentration gradient across placenta
Name the 4 drug properties affecting drug transfer across the placenta. For each of the property, state under what condition it facilitates the transfer.
- Molecular weight: LOW increases transfer
- Ionization: LOW increases transfer
- Lipophilicity : HIGH increases transfer
- Protein binding: FREE increases transfer
True or false: drugs are most likely passing into breast-milk with different physiochemical properties that allow them to transfer across the placenta.
False.
True or false: tobacco crosses the placenta.
True.
Name the two mechanisms of fetal harm of tobacco.
-Increase of nicotine and CO2 levels -> vasoconstriction -> reduces oxygen levels
-Nicotine increases the levels of collateral chemicals causing deregulation in fetal development
List five obstetrical complications associated with tobacco use during pregnancy.
-Miscarriage
-Placenta abruption
-Placenta previa (when the placenta completely or partially covers the opening of the uterus)
-Premature rupture of membranes
-Uterine infections
List five neonatal complications associated with tobacco use during pregnancy.
-Low birth weight
-Fetal growth restriction
-Increased risk of sudden infant death syndrome (SIDS)
-Stillbirth
-Premature births
List six childhood complications associated with tobacco use during pregnancy.
-SIDS
-Increased risk for asthma
-Congetinal heart defects (increased risks for first trimester)
-Diabetes
-Cognitive ability
-Cleft lip
Nicotine is readily absorbed into breast milk. What is a potentially fatal consequence from this?
SIDS.
Name 4 effects on the newborn that may cause nicotine presence in breast-milk.
-SIDS
-Reduced appetite
-Decrease milk supply
-Sleep disturbances
What is the consequence of the fetus liver being underdeveloped when the mother importantly consumes alcohol?
Unable to completely eliminate ethanol.
At what trimester is the fetus more susceptible to teratogenic effects of ethanol?
First trimester.
What is the primary cellular mechanism of fetal harm of alcohol?
Production of reactive oxygen species from the metabolization of ethanol that interact with DNA, protein and lipids.
List 3 obstetrical complications associated with alcohol use during pregnancy.
-Intrauterine growth restriction
-Increased risk of stillbirth
-Increased risk of miscarriage