Substance misuse in pregnancy

Question 1

What is the impact of alcohol use in pregnancy

Answer 1

Cognitive and behavioural abnormalities
Miscarriage, stillbirth, infant mortality, congenital abnormalities, LBW, preterm delivery, SGA
Foetal alcohol spectrum disorders → neurodevelopmental abnormalities
Executive functioning defects, psychosocial consequences in adulthood

Question 2

What is the impact of smoking in pregnancy

Answer 2

Damage to umbilical cord structure
Increased risk of ectopic pregnancy
Placental abruption
Miscarriage
LBW and preterm birth
Increased foetal mortality

Question 3

What is the impact of cannabis use in pregnancy

Answer 3

Preterm labour, LBW, SGA, increased NICU admission
Adverse consequences of growth and adolescent brains
Reduced attention and executive functioning skills
Poorer academic achievement
Behavioural problems

Question 4

What is the impact of cocaine use in pregnancy

Answer 4

PROM, preterm birth
Placental abruption
LBW, SGA

Question 5

What is the impact of methamphetamine use in pregnancy

Answer 5

Shorter gestational age
LBW
Foetal loss
Developmental and behavioural defects
Pre-eclampsia
Gestational HTN
Intrauterine foetal death

Question 6

What is the impact of opioid use in pregnancy

Answer 6

LBW
Respiratory problems
3rd trimester bleeding
Toxaemia
Mortality
Growth deficiency
Behavioural problems
SIDS
Microcephaly
Neonatal abstinence syndrome

Question 7

What is neonatal abstinence syndrome

Answer 7

Opiate exposure in utero → triggers postnatal withdrawal syndrome
Occurs in 45-94% of infants exposed to opioids in utero
→ substantial neonatal morbidity + healthcare utillisation

Question 8

What are the features of neonatal abstinence syndrome

Answer 8

Irritability
Feeding difficulties, emesis
Hypertonia, seizures
Respiratory distress
Loose stools
Tremors