IUDE; Intrauterine drug exposure; Maternal drug abuse
Maternal substance abuse may consist of any combination of drug, chemical, alcohol, or smoking use during the pregnancy.
While in the womb, a fetus grows and develops due to the nourishment from the mother via the placenta. However, along with nutrients, any toxins in the mother’s system may be delivered to the fetus. These toxins often cause damage to the developing fetal organs.
WHAT CAUSES SUBSTANCE ABUSE DURING PREGNANCY?
Unfortunately, many women use drugs and alcohol for recreation before they know they are pregnant. Others continue to abuse drugs while pregnant as a result of addictions or mental problems that cannot be controlled.
WHAT ARE THE SIGNS AND SYMPTOMS SEEN IN AN INFANT OF A SUBSTANCE ABUSING MOTHER?
Babies born to substance abusing mothers may have short- or long-term effects. Short-term withdrawal symptoms vary from mild fussiness to significant issues with irritability, feeding, jitteriness, and diarrhea. The diagnosis for babies with clinical findings of withdrawal can often be confirmed with results from drug testing the baby’s urine or stool.
More significant long-term developmental problems may be seen in babies who are born with growth or various organ problems. Infants born to mothers who drink, even in modest amounts, may be born with the fetal alcohol syndrome, which often consists of growth problems, unusual facial features, and intellectual disability. Other drugs may cause malformations of the heart, brain, bowel, or kidneys that can have significant impact on long-term development and outcome.
WHAT IS THE TREATMENT FOR AN INFANT OF A SUBSTANCE ABUSING MOTHER?
Depending on the drugs the mother used, a baby's treatment may involve limiting stimulation to using sedatives. Sedatives are slowly "weaned" or lessended over days to weeks. Infants with organ damage or neurodevelopmental issues may need medical or surgical therapy and long-term developmental assistance.
Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.