CHAPTER 17
Chemicals and the Neonate: The Potential Consequences of Drug Use During Pregnancy
LEARNING OBJECTIVES
After studying this chapter, students should be able to:
•
17.2: Identify the concerns with alcohol use during pregnancy
•
17.3: Identify the concerns with various drugs if used during pregnancy
CHAPTER OUTLINE
Scope of the Problem
A Period of Special Vulnerability
Alcohol
Scope of the Problem
Consequences of Maternal Alcohol Use
Other Consequences of Maternal Alcohol Use
Breast Feeding and Alcohol Use
Disulfiram Use During Pregnancy
Use of Amphetamines and Amphetamine-Like Compounds During Pregnancy
Amphetamine Use and Breast-Feeding
Barbiturate and Barbiturate-Like Drug Use During Pregnancy
Benzodiazepine Use During Pregnancy
Benzodiazepine Use During Breast-Feeding
Buspirone Use During Pregnancy
Cigarette Smoking During Pregnancy
Prenatal Exposure to Environmental Tobacco Smoke
Maternal Use of “E-Cigarettes” (Electronic Cigarettes)
Smoking and Breast-Feeding
Nicotine Replacement Therapy (NRT) During Pregnancy
Bupropion Use During Pregnancy
Cocaine Use During Pregnancy
Cocaine and Breast-Feeding
Hallucinogen Use During Pregnancy
LSD Use During Pregnancy
MDMA Use During Pregnancy
PCP Use During Pregnancy
Salvia Divinorum Use During Pregnancy
Inhalant Misuse During Pregnancy
Marijuana Use During Pregnancy
Marijuana and Breast-Feeding
Narcotic Analgesic Use During Pregnancy
Statement of the Problem
Maternal Narcotics Misuse and Breast-Feeding
Aspirin
Acetaminophen
Ibuprofen
Caffeine During Pregnancy
CHAPTER OVERVIEW
The purpose of this chapter is to discuss an aspect of the problem of the substance use
disorders that is rarely acknowledged: that maternal alcohol or drug use makes the unborn child
an unwilling user of these compounds. However, the issue of how maternal drug use might alter
neonatal growth and development is a controversial one and is subject to change as new
information is brought to light. In this chapter, the effects of maternal use of various compounds
on neonatal growth and development are discussed, providing the student with an overview of
the dangers associated with maternal drug and alcohol use during pregnancy.
DISCUSSION QUESTIONS
Break-Out Discussion #1:
Prenatal exposure to cigarettes: Cigarette smoking remains common in the United States in
spite of spirited efforts to assist individuals in quitting. It is not viewed as a form of “drug
misuse” by most people. Yet it has been found that prenatal exposure to cigarette smoke in
Questions
1. Does society have the right to step in to protect the fetus from prenatal nicotine exposure in
the same way that it attempts to do with prenatal cocaine exposure? Why or why not?
2. Should a woman be expected to pay a higher price for cigarettes than a man of the same age
so that the extra money would go into a fund to pay for treatment and support services for her
unborn child, should he or she require this assistance? Why or why not? Should such support
services exist, and if so, how should they be funded?
Break-Out Discussion #2:
A moral question. Should the woman who gives birth to a child with fetal alcohol syndrome
(FAS) be penalized in some manner? The child will require economic and psychosocial support,
her pregnancy. The mother’s alcohol use behaviors during pregnancy are the sole determinant
whether the infant develops FAS.
So, should she be penalized if the child should be born with this disorder?
The answer to this question is a bit more complicated than a simple yes or no, however. Many
infants who have FAS have a mild form of the disorder that might not even be recognized by a
physician with great experience in working with children with FAS. Even the most severe form
can be difficult to diagnose at times. The subtle forms of FAS would be exceptionally difficult to
definitively diagnose, and the danger would exist that the mother would be penalized for a
condition that the infant did not have.
The conundrum is this: FAS can be entirely prevented by the simple expedient of maternal
abstinence from alcohol during pregnancy. One solution would be to require that women
In addition, is research into prenatal drug exposure sexist? At first this question may seem
unrealistic; after all, it is the mother who carries and delivers the infant. Thus, the majority of
the research to date has been on the impact of maternal substance use on fetal growth and
development. However, is the father’s contribution unimportant? Exposure to several industrial
Questions
1. Should a mother (or both parents) be penalized for fetal alcohol exposure? What if the
exposure is inadvertent?
2. Are there other aspects to this problem that have not been identified? What are they?
3. What do you think about this whole issue? Should women who give birth to a child with FAS
be penalized? Why or why not?
Reference
KEY CONCEPTS AND TERMS
Meconium: A thick, green, tar-like substance that lines the intestinal tract of the fetus. This
substance is usually excreted by the infant in the first few days after birth. Occasionally it is
Dissimulation: A situation where the client provides false information in response to a question
or test item
Teratogen: A compound that permanently interferes with normal fetal growth and development
Agenesis: Failure of development in, or damage to, a specific body organ during prenatal
development
Corpus callosum: Region of the brain that transfers information from one hemisphere to the
other
Confounding variable: A variable in a research study that potentially can alter the outcome of
Vertical transmission: Passing a virus from mother to infant, either during gestation or through
giving birth
LO/STANDARDS CORRELATION CHART
A-head
LO
Standard—CACREP
Scope of the Problem
17.1:
Understand
the scope of
the problem
of substance
misuse
during
pregnancy
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
Alcohol
17.2: Identify
the concerns
with alcohol
use during
pregnancy
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
Amphetamine-Like
Compounds During
Pregnancy
Barbiturate and
Barbiturate-Like Drug Use
During Pregnancy
Benzodiazepine Use
During Pregnancy
Cigarette Smoking During
Pregnancy
Cocaine Use During
Pregnancy
Hallucinogen Use During
Pregnancy
Inhalant Misuse During
Pregnancy
Pregnancy
Caffeine During Pregnancy
the concerns
with various
drugs if used
during
pregnancy
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior