Women’s use of alcohol and psychoactive substances before conception and during pregnancy is common and occurs in all ethnic groups, all socio-economic strata and all geographic regions of the U.S. The biologic and social effects of substance use on perinatal outcomes and on the long-term physical and psychological development of exposed children are not fully understood, despite active research for over three decades. Though substantial evidence exists to link substance use in pregnancy to a wide variety of adverse maternal, fetal and neonatal outcomes, it is often not possible to attribute a specific negative outcome directly to the effects of a particular substance. Many adverse outcomes are due to the effects of multiple drugs, drugs and alcohol used in combination, and these combined with concurrent tobacco use. Since smoking is the focus of another chapter in this volume, this chapter will focus primarily on the use of alcohol as well as illicit and illegal drugs during pregnancy. (Please see Box 12.1 for explanation of how these terms are used here).
- Pregnant Woman
- Illicit Drug
- Prenatal Care
- Perinatal Outcome
- Fetal Alcohol Spectrum Disorder
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Use of the word “substance” in this chapter refers to any solid, liquid, or vapor that can be ingested orally, inhaled, sniffed, snorted, smoked, or injected into the body, for the purpose of mood alteration whether for recreational purposes, for self-medicating physical or emotional symptoms, or other reasons.
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It should be noted that the term substance abuse rather than use is frequently employed in perinatal research and clinical practice. This is because any use of illegal mood altering drugs, any illicit use of pharmaceutically produced mood altering drugs (see below) or any use of alcohol by pregnant women has historically been considered abuse under an extrapolation of Criteria #1 for Substance Abuse, which assumes that substance use in pregnancy constitutes high probability of risk of harm to maternal health or potential harm to fetal growth and well-being.
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Carlberg-Racich, S., Mason, E. (2011). Substance Use in Pregnancy: The Impact of Screening and Treatment on Improving Perinatal Outcomes and Reducing Racial and Ethnic Disparities. In: Handler, A., Kennelly, J., Peacock, N. (eds) Reducing Racial/Ethnic Disparities in Reproductive and Perinatal Outcomes. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1499-6_12
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