AAP Describes Damaging Effects of Substance Abuse on the Developing Fetus

The American Academy of Pediatrics (AAP) technical report, “Prenatal Substance Abuse: Short- and Long-term Effects on the Exposed Fetus,” in the March 2013 Pediatrics (published online Feb. 25), provides information for the most common substances involved in fetal exposure: nicotine, alcohol, marijuana, opiates, cocaine and methamphetamines.

Substance use during pregnancy can adversely affect a growing fetus. Early in pregnancy, fetal malformations may occur while, later in pregnancy, it is the developing fetal brain that is more vulnerable to injury. The effects of fetal substance exposure may include stunted growth or more subtle findings like alterations in neurobehavior. Alcohol is the most-often studied drug of abuse and can cause several fetal problems including restricted fetal growth, congenital anomalies, behavior problems, poor memory and intellectual disabilities. Prenatal nicotine exposure has been associated with brain development issues, cognition, language, achievement, and long-term behavior.

The AAP report concludes that the primary care pediatrician’s role in addressing prenatal substance use should include prevention, identification of exposure, recognition of medical issues for the exposed newborn infant, and regular follow-up to monitor any long-term effects.