Drugs use by pregnant women can result in harm to unborn children. The
March of Dimes provides information about pregnancy and the use of legal
drugs such as tobacco and alcohol and illegal drugs such as cocaine, PCP,
and heroin. Because some prescription and over-the-counter drugs can also
harm unborn children, the March of Dimes recommends that pregnant women
speak to their doctors before taking any medication. Additional information
about smoking and drinking alcohol while pregnant is available in the Center
for Evaluation of Risks to Human Reproduction (CERHR) website under
Common Concerns and Exposures.
The March of Dimes (MOD
2004) offers the following information about cocaine use during
What are the risks with use of cocaine during pregnancy?
Cocaine use during pregnancy can affect a
pregnant woman and her unborn baby in many ways. During the early months of
pregnancy, it may increase the risk of miscarriage. Later in pregnancy, it
can trigger preterm labor (labor that occurs before 37 weeks of pregnancy)
or cause the baby to grow poorly. As a result, cocaine-exposed babies are
more likely than unexposed babies to be born with low birthweight (less than
5½ pounds). Low-birthweight babies are 20 times more likely to die in their
first month of life than normal-weight babies, and face an increased risk of
lifelong disabilities such as mental retardation and cerebral palsy.
Cocaine-exposed babies also tend to have smaller heads, which generally
reflect smaller brains.
Some studies suggest that cocaine-exposed babies
are at increased risk of birth defects, including urinary-tract defects and,
possibly, heart defects. Cocaine also may cause an unborn baby to have a
stroke, which can result in irreversible brain damage or a heart attack, and
Cocaine use also may cause the placenta to pull
away from the wall of the uterus before labor begins. This condition, called
placental abruption, can lead to extensive bleeding and can be fatal for
both mother and baby. (Prompt cesarean delivery, however, can prevent most
Babies who were regularly exposed to cocaine
before birth may score lower than unexposed babies on tests given at birth
to assess the newborn's physical condition and overall responsiveness. They
may not do as well as unexposed babies on measures of motor ability,
reflexes, attention and mood control, and they appear less likely to respond
to a human face or voice.
Babies who are regularly exposed to cocaine
before birth sometimes have feeding difficulties and sleep disturbances. As
newborns, some are jittery and irritable, and they may startle and cry at
the gentlest touch or sound. Therefore, these babies may be difficult to
comfort and may be described as withdrawn or unresponsive. Other
cocaine-exposed babies "turn off" surrounding stimuli by going into a deep
sleep for most of the day. Generally, these behavioral disturbances are
temporary and resolve over the first few months of life. Some studies
suggest that cocaine-exposed babies have a greater chance of dying of sudden
infant death syndrome (SIDS). However, other studies suggest that poor
health practices that often accompany maternal cocaine use (such as use of
other drugs) also may play a major role in these deaths.
What is the long-term outlook for babies who
were exposed to cocaine before birth?
Some studies suggest that most children who are
exposed to cocaine before birth have normal intelligence. This is
encouraging, in light of earlier predictions that many of these children
would be severely brain damaged. A 2002 study at Harvard Medical School and
Boston University found that children up to age 2 who were heavily exposed
to cocaine before birth scored just as well on tests of infant development
as lightly exposed or unexposed children. However, other studies suggest
that cocaine may sometimes affect mental development, possibly lowering IQ
A 2002 study at Case Western Reserve University
found that cocaine-exposed 2-year-olds were twice as likely as unexposed
children from similar low socioeconomic backgrounds to have significant
delays in mental development (14 percent and 7 percent, respectively). It is
not known whether these children will continue to have learning problems
when they reach school age.
Studies are inconclusive regarding the risk of
learning and behavioral problems. Studies from the National Institute on
Drug Abuse suggest that most adolescents who were exposed to cocaine before
birth seem to function normally. However, some may have subtle impairments
in the ability to control emotions and focus attention that could put them
at risk of behavioral and learning problems. Other studies suggest that
cocaine exposure may adversely affect language abilities. Researchers
continue to follow cocaine-exposed children through their teen years to
clarify their long-term outlook.
Marijuana is often mistakenly viewed as a "safe" drug. However, a study
funded by the National Institute on Drug Abuse (NIDA) and the National
Institute on Child Health and Human Development (NICHD) suggests that
exposure to cannabinoids, psychoactive chemicals present in marijuana, can
affect early embryonic development. More information about this study can
be found at:
information concerning the effects of marijuana use during pregnancy can be
The March of Dimes (MOD
2004) offers the following information about marijuana use and
What are the risks with use of marijuana
Some studies suggest that use of marijuana
during pregnancy may slow fetal growth and slightly decrease the length of
pregnancy (possibly increasing the risk of premature delivery). Both of
these factors can increase a woman's chance of having a low-birthweight
baby. These effects are seen mainly in women who use marijuana regularly
(six or more times a week).
After delivery, some babies who were regularly
exposed to marijuana in the womb appear to undergo withdrawal-like symptoms
including excessive crying and trembling.
Couples who are planning pregnancy also should
keep in mind that marijuana can reduce fertility in both men and women,
making it more difficult to conceive.
What is the long-term outlook for babies
exposed to marijuana before birth?
There have been a limited number of studies
following marijuana-exposed babies through childhood. Some did not find any
increased risk of learning or behavioral problems. However, others found
that children who are exposed to marijuana before birth are more likely to
have subtle problems that affect their ability to pay attention and to solve
visual problems. Exposed children do not appear to have a decrease in IQ.
Many medicines are relatively safe to take while you are pregnant, but
some are not. Here are some tips from the National Women's Health
Information Center (National
Women's Health Information Center 2002) for using medicines safely:
Many drugs that you can buy over-the-counter
(OTC) in drug and discount stores, and drugs your health care provider
prescribes are thought to be safe to take during pregnancy, although there
are no medicines that are proven to be absolutely safe when you are
pregnant. Many of these products tell you on the label if they are thought
to be safe during pregnancy. If you are not sure you can take an OTC
product, ask your health care provider.
Some drugs are not safe to take during
pregnancy. Even drugs prescribed to you by your health care provider before
you became pregnant might be harmful to both you and the growing fetus
during pregnancy. Make sure all of your health care providers know you are
pregnant, and never take any drugs during pregnancy unless they tell you to.
Also, keep in mind that
other things like caffeine, vitamins, and herbal teas and remedies can
affect the growing fetus. Talk with your health care provider about cutting
down on caffeine and the type of vitamins you need to take. Never use any
herbal product without talking to your health care provider first.
See the following sites for more information on prescription and