Drug-Exposed Infants

Abstract

Recent studies have documented that an increasing number of women of childbearing age are using licit and illicit substances. Although statistical data are insufficient, there are indications that approximately 1 in 10 infants may have been exposed to illicit drugs in utero. The Office of Applied Studies 1992 National Household Survey1 revealed that 6.8% of women of childbearing age admitted to having used an illicit drug in the month before questioning. Recent state surveys have shown that between 8% and 12% of women delivering in their hospitals had used illegal drugs at some time during the pregnancy, including just before delivery.2-5 These studies support information from a study in Pinellas County, FL, which demonstrated that illicit substance use during pregnancy occurs in all racial and socioeconomic lines.6,7 In addition to the use of illegal drugs, the use of alcohol or nonprescribed drugs shortly before delivery is also identified as a problem.8 These incidence data parallel the increasing number of infants being admitted to special-care nurseries for complications caused by intrauterine exposure to alcohol and other drugs. Drug-exposed infants also often go unrecognized and are discharged from the newborn nursery at increased risk for a complex of medical and social problems, including abuse and neglect. This statement addresses illicit substance use in pregnancy and its medical, educational, social, mental health, and legal consequences for children and families. The Academy recently has developed a separate statement to address the issue of infants exposed to alcohol in utero.9 The Problem All illicit drugs reach the fetal circulation by crossing the placenta and can cause direct toxic effects on the fetus, as well as fetal and maternal dependency.10