Alcohol and Other Drug Use During Pregnancy: The Facts

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by Nancy Poole

Pregnant women who use alcohol and other drugs risk having a child affected by fetal alcohol syndrome (FAS) and other alcohol and drug-related developmental disabilities (ADRDD). This risk rises:

  • with the amount of alcohol used
  • with smoking
  • with the use of other drugs in addition to alcohol
  • if a woman is poorly nourished
  • if she is subject to stressful life events
  • if she is in poor overall health, and
  • if she does not access prenatal care.

FAS is the only alcohol/drug-related birth defect with specific diagnostic criteria. The three specific criteria for FAS are: deficiencies in growth; characteristic facial features; and impairment to the central nervous system. The impairment to the central nervous system may be mild to severe, resulting in problems such as intellectual retardation, learning disabilities, difficulty with memory, and difficulty understanding cause and effect.

Those affected by FAS are also at higher risk for birth defects such as abnormalities of the eyes, ears, organs, skeleton and immune system. There is a great deal of variability in outcome. The impact of FAS lasts a lifetime, and the manifestations of the problems change as the child develops. The developmental problems associated with FAS can be helped by early and supportive intervention.

Tobacco use during pregnancy is associated with the risk of premature birth, low birth weight, and higher risk of crib death. There is also an increased risk of ear infections and breathing problems in children. There may be an association with later attention deficit and developmental delays.

Many tend to assume that the problems associated with illicit drug use in pregnancy are more severe than those associated with alcohol. Current research shows, however, that the problems associated with prenatal exposure to drugs such as cocaine are not as severe as the long-term problems associated with alcohol exposure.

Cocaine use during pregnancy is associated with the risk of miscarriage; premature birth; stroke during labour and delivery; malformations of the limbs and kidney; and possible later learning difficulties.

There is an emerging literature of descriptive case reports on the impact of fetal exposure to solvents. These effects include miscarriages, premature births, low birth weights, physical deformities and developmental delays. However, because it is rare to find solvent users who don't use alcohol or other drugs concurrently, it is difficult to be certain which of these effects can be attributed solely to solvents. Much more research is needed in order to fully describe the potential impact of solvent use during pregnancy.

Nancy Poole is a consultant with the Aurora Centre at the Children's and Women's Health Centre of B.C. She also works with the British Columbia Centre of Excellence for Women's Health.