IUDE; Intrauterine drug exposure; Maternal drug abuse
Maternal substance abuse may consist of any combination of drug, chemical, alcohol, and/or tobacco use during the pregnancy.
While in the womb, a fetus grows and develops due to 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 may 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 use drugs while pregnant as a result of addictions or psychiatric problems.
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. Symptoms are different for different substances. The diagnosis for babies with clinical findings of withdrawal may 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 failure or various organ problems. Infants born to mothers who drink alcohol, even in modest amounts, may be born with the fetal alcohol syndrome, which 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. Babies who have been exposed to drugs, alcohol and/or cigarettes are at higher risk for SIDS (sudden infant death syndrome).
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, such as noise and bright lights, maximizing "TLC" (tender loving care), and possibly using medication. In the case of babies whose mothers used narcotics, a narcotic is usually given to the baby in a small dose that can be carefully adjusted and then slowly "weaned" or decreased over days to weeks. Sedatives are sometimes used as well. Infants with organ damage or neurodevelopmental issues may need medical or surgical therapy and long-term developmental assistance.
Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network.