Pay Attention To Substance Use

 

Pregnancy is an exquisitely sensitive period for mothers and their gestating fetuses. We know a lot of substances that inadvertently make their way into the bloodstream via inhalation or ingestion can interfere with maternal health and fetal growth and development, even at very low levels of exposure. That’s why health professionals who care for women who are pregnant advise “clean” living before, during, and after pregnancy during lactation, while stressing avoidance of chemicals that are present in our homes, in our food and water, and in the air we breathe.

Exposure to some toxic substances, however, can be self-inflicted. Using tobacco, alcohol, and illicit drugs is clearly forbidden during pregnancy for reasons that are well known. Smoking during pregnancy increases the risk of pregnancy complications, including miscarriage, prematurity, low birth weight, and birth defects. Once born, babies whose mothers smoke are about three times more likely to die from sudden infant death syndrome (SIDS), according to data from the Centers for Disease Control and Prevention.

All types of alcohol can harm a developing fetus, even small amounts of beer, wine, and spirits. Like tobacco, drinking while pregnant increases the risk of miscarriage, prematurity, SIDS, and fetal alcohol syndrome (FAS). Infants born with FAS can have a variety of physical ailments resulting from organ damage and brain injury, and cognitive and behavioral disabilities.

Illicit drug use during pregnancy presents its own array of obstacles for a developing fetus. Even marijuana — fully legal or decriminalized for adults in 30 states and the District of Columbia — is not a benign substance to be used during pregnancy.

The CDC calls opioid use disorder in pregnant women “a significant public health concern in the United States:

The number of pregnant women with opioid use disorder at labor and delivery more than quadrupled from 1999 to 2014, according to a recent CDC analysis. Opioid use disorder during pregnancy has been linked with serious negative health outcomes for pregnant women and developing babies, including preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome (NAS).

 

A recent study connects the use of these substances during pregnancy to the development of attention-deficit/hyperactivity disorder in childhood, “a complex neurodevelopmental condition diagnosed in approximately 1 in 10 children,” according to the study’s authors:

Use of tobacco, opioids, alcohol and other substances during pregnancy increases the risk that newborns will develop attention-deficit/hyperactivity disorder as they age, a study published Friday by JAMA Network Open found.

Children whose mothers used opioids during pregnancy, for example, had more than double the risk for attention-deficit/hyperactivity disorder, or ADHD, compared to those whose mothers avoided the drugs, the data showed.

 

The most frequently used substance in pregnancy is tobacco, followed by alcohol, cannabis, and other drugs. Brian P. Dunleavy discovered that prenatal polysubstance exposure is particularly problematic:

People who used more than one substance during pregnancy, combining tobacco and marijuana or opioids and alcohol, for example, raised their child’s risk for developing ADHD by nearly 50%, the researchers said.

 

Using one substance is bad enough for a developing fetus. Using two or more, the study concludes, can make matters significantly worse:

[T]his cohort study found that any increase in the number of substances used during gestation was associated with increases in the risk of developing ADHD in later childhood, and exposures to opioids combined with cannabis and opioids combined with tobacco smoking were of particular concern.

 

 

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source http://www.thepediablog.com/2022/03/29/pay-attention-to-substance-use/