Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-26T03:05:06.927Z Has data issue: false hasContentIssue false
  • English
  • Français

SUBSTANCE MISUSE DURING PREGNANCY: ITS EFFECTS AND TREATMENT

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  01 February 2009

P MORAN ,
RM MADGULA ,
E GILVARRY  and
M FINDLAY
P MORAN*
Affiliation:
Womens' Services, 2nd Floor, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne.
RM MADGULA
Affiliation:
Tees, Esk and Wear Valleys NHS Foundation Trust, Earls House Hospital, Lanchester Road, Durham. Northumberland, Tyne and Wear NHS Trust, Plummer Court, Carliol Place, Newcastle upon Tyne NE1 6UR.
E GILVARRY
Affiliation:
Northumberland, Tyne and Wear NHS Trust, Plummer Court, Carliol Place, Newcastle upon Tyne NE1 6UR.
M FINDLAY
Affiliation:
Womens' Services, 2nd Floor, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne.
*
Dr Paul Moran, Womens' Services, 2nd Floor, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP.
Get access Rights & Permissions [Opens in a new window]

Extract

Prenatal care reduces the impact of illicit drug use on perinatal outcomes. Women who misuse substances are often excluded from mainstream society and, on becoming pregnant, feel guilty about their drug misuse and the potential effects this could have on their unborn baby. These women are vulnerable in many ways and agencies must ensure that they are not excluded from antenatal care. The latest enquiry into maternal deaths published in the UK (CEMACH report) highlights how women with socially complex lives who died were far less likely to have sought antenatal care early in pregnancy or to remain in regular contact with maternity services. Of the women who died from any cause, 11% had problems with substance abuse of whom 60% were registered addicts. Gaps in communication between agencies was highlighted as a particular problem.

Type
Research Article
Information
Fetal and Maternal Medicine Review , Volume 20 , Issue 1 , February 2009 , pp. 1 - 16
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1El-Mohandes, A, Herman, AA, Nabil El-Khorazaty, M, Katta, PS, White, D, Grylack, L. Prenatal care reduces the impact of illicit drug use on perinatal outcomes. J Perinatol 2003; 23: 354–60.CrossRefGoogle ScholarPubMed
2Saving mothers lives: Reviewing maternal deaths to make motherhood safer 2003–2005. In: Lewis G, (ed). CEMACH 2007.Google Scholar
3Hidden Harm: Responding to the Needs of Children of Problem Drug Users. London. Advisory Council for the Misuse of Drugs. 2003.Google Scholar
4BMA. Fetal alcohol spectrum disorders. London, British Medical Association. 2007.Google Scholar
5Brady, KT, Verduin, ML, Tolliver, BK. Treatment of patients comorbid for addiction and other psychiatric disorders. Curr Psychiatry Rep. 2007; 9: 374–80.CrossRefGoogle ScholarPubMed
6Gual, A. Dual diagnosis in Spain. Drug Alcohol Review. 2007; 26: 65–71.CrossRefGoogle ScholarPubMed
7Viguera, AC, Nonacs, R, Cohen, LS, Tondo, L, Murray, A, Baldessarini, RJ. Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry 2000; 157: 179–84.CrossRefGoogle ScholarPubMed
8Fischer, G, Johnson, RE, Eder, H, Jagsch, R, Peternell, A, Weninger, M, et al. Treatment of opioid-dependent pregnant women with buprenorphine. Addiction 2000; 95: 239–44.CrossRefGoogle ScholarPubMed
9The common assessment framework for children & young people: practitioners' guide. [London]: Department for Education and Skills 2006.Google Scholar
10World Health Organisation. Statistical Classification of Diseases and Related Health Problems 10th Revision. 2007.Google Scholar
11Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. 2008; 4th Edition.Google Scholar
12Mitchell, EA, Milerad, J. Smoking and the sudden infant death syndrome. Rev Environ Health 2006; 21: 81–103.CrossRefGoogle ScholarPubMed
13Hurd, YL, Wang, X, Anderson, V, Beck, O, Minkoff, H, Dow-Edwards, D. Marijuana impairs growth in mid-gestation fetuses. Neurotoxicol Teratol 2005; 27: 221–29.CrossRefGoogle ScholarPubMed
14Fergusson, DM, Horwood, LJ, Northstone, K. Maternal use of cannabis and pregnancy outcome. BJOG 2002; 109: 21–7.CrossRefGoogle ScholarPubMed
15Strang, J, Marsden, J, Cummins, M, Farrell, M, Finch, E, Gossop, M, et al. Randomized trial of supervised injectable versus oral methadone maintenance: report of feasibility and 6-month outcome. Addiction 2000; 95: 1631–645.CrossRefGoogle ScholarPubMed
16Hulse, GK, Milne, E, English, DR, Holman, CD. The relationship between maternal use of heroin and methadone and infant birth weight. Addiction 1997; 92: 1571–579.CrossRefGoogle ScholarPubMed
17Lingford-Hughes, AR, Welch, S, Nutt, DJ. Evidence-based guidelines for the pharmacological management of substance misuse, addiction and comorbidity: recommendations from the British Association for Psychopharmacology. J Psychopharmacol (Oxford, England). 2004; 18: 293–335.CrossRefGoogle ScholarPubMed
18McElhatton, PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol 1994; 8: 461–75.CrossRefGoogle ScholarPubMed
19Dolovich, LR, Addis, A, Vaillancourt, JM, Power, JD, Koren, G, Einarson, TR. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. Br Med J 1998; 317: 839–43.CrossRefGoogle ScholarPubMed
20Wikner, BN, Stiller, CO, Bergman, U, Asker, C, Kallen, B. Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations. Pharmacoepidemiol Drug Saf 2007; 16: 1203–10.CrossRefGoogle ScholarPubMed
21Harrison, R. The use of non-essential drugs, alcohol and cigarettes during pregnancy. Ir Med J 1986; 79: 338–41.Google ScholarPubMed
22Sutton, LR, Hinderliter, SA. Diazepam abuse in pregnant women on methadone maintenance. Implications for the neonate. Clin Pediatr 1990; 29: 108–11.CrossRefGoogle ScholarPubMed
23United Nations Office on Drugs and Crime. World Drug Report. Vienna 2004; 1.Google Scholar
24Arria, AM, Derauf, C, Lagasse, LL, Grant, P, Shah, R, Smith, L, et al. Methamphetamine and other substance use during pregnancy: preliminary estimates from the Infant Development, Environment, and Lifestyle (IDEAL) study. Maternal Child Health J 2006; 10: 293–302.CrossRefGoogle ScholarPubMed
25Smith, LM, LaGasse, LL, Derauf, C, Grant, P, Shah, R, Arria, A, et al. The infant development, environment, and lifestyle study: effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth. Pediatrics 2006; 118: 1149–156.CrossRefGoogle ScholarPubMed
26Smith, LM, Lagasse, LL, Derauf, C, Grant, P, Shah, R, Arria, A, et al. Prenatal methamphetamine use and neonatal neurobehavioral outcome. Neurotoxicol Teratol 2008; 30: 20–28.CrossRefGoogle ScholarPubMed
27Smith, L, Yonekura, ML, Wallace, T, Berman, N, Kuo, J, Berkowitz, C. Effects of prenatal methamphetamine exposure on fetal growth and drug withdrawal symptoms in infants born at term. J Dev Behav Pediatr 2003; 24: 17–23.CrossRefGoogle ScholarPubMed
28Bada, HS, Das, A, Bauer, CR, Shankaran, S, Lester, B, Wright, LL, et al. Gestational cocaine exposure and intrauterine growth: maternal lifestyle study. Obstet Gynecol 2002; 100: 916–24.Google ScholarPubMed
29Bhuvaneswar, CG, Chang, G, Epstein, LA, Stern, TA. Cocaine and opioid use during pregnancy: prevalence and management. Prim Care Companion J Clin Psychiatry 2008; 10: 59–65.CrossRefGoogle ScholarPubMed
30Burkett, G, Yasin, SY, Palow, D, LaVoie, L, Martinez, M. Patterns of cocaine binging: effect on pregnancy. Am J Obstet Gynecol 1994; 171: 372–78; discussion 8–9.CrossRefGoogle ScholarPubMed
31Addis, A, Moretti, ME, Ahmed Syed, F, Einarson, TR, Koren, G. Fetal effects of cocaine: an updated meta-analysis. Reprod Toxicol. 2001; 15: 341–69.CrossRefGoogle ScholarPubMed
32Acker, D, Sachs, BP, Tracey, KJ, Wise, WE. Abruptio placentae associated with cocaine use. Am J Obstet Gynecol 1983; 146: 220–21.CrossRefGoogle ScholarPubMed
33Little, BB, Snell, LM, Trimmer, KJ, Ramin, SM, Ghali, F, Blakely, CA, et al. Peripartum cocaine use and adverse pregnancy outcome. Am J Hum Biol 1999; 11: 598–602.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
34Hulse, GK, Milne, E, English, DR, Holman, CD. Assessing the relationship between maternal cocaine use and abruptio placentae. Addiction 1997; 92: 1547–551.CrossRefGoogle ScholarPubMed
35Eyler, FD, Behnke, M, Conlon, M, Woods, NS, Wobie, K. Birth outcome from a prospective, matched study of prenatal crack/cocaine use: I. Interactive and dose effects on health and growth. Pediatrics 1998; 101: 229–37.CrossRefGoogle ScholarPubMed
36Sprauve, ME, Lindsay, MK, Herbert, S, Graves, W. Adverse perinatal outcome in parturients who use crack cocaine. Obstet Gynecol 1997; 89: 674–78.CrossRefGoogle ScholarPubMed
37Hulse, GK, English, DR, Milne, E, Holman, CD, Bower, CI. Maternal cocaine use and low birth weight newborns: a meta-analysis. Addiction 1997; 92: 1561–70.CrossRefGoogle ScholarPubMed
38Bauer, CR, Langer, JC, Shankaran, S, Bada, HS, Lester, B, Wright, LL, et al. Acute neonatal effects of cocaine exposure during pregnancy. Arch Pediatr Adolesc Med 2005; 159: 824–34.CrossRefGoogle ScholarPubMed
39Behnke, M, Eyler, FD, Warner, TD, Garvan, CW, Hou, W, Wobie, K. Outcome from a prospective, longitudinal study of prenatal cocaine use: preschool development at 3 years of age. J Pediatr Psychol 2006; 31: 41–49.CrossRefGoogle ScholarPubMed
40Frank, DA, Augustyn, M, Knight, WG, Pell, T, Zuckerman, B. Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review. JAMA 2001; 285: 1613–625.CrossRefGoogle ScholarPubMed
41Winklbaur, B, Kopf, N, Ebner, N, Jung, E, Thau, K, Fischer, G. Treating pregnant women dependent on opioids is not the same as treating pregnancy and opioid dependence: a knowledge synthesis for better treatment for women and neonates. Addiction 2008; 103: 1429–440.CrossRefGoogle ScholarPubMed
42Minozzi, S, Amato, L, Vecchi, S, Davoli, M. Maintenance agonist treatments for opiate dependent pregnant women. Cochrane database of systematic reviews (Online). 2008(2):CD006318.CrossRefGoogle Scholar
43Mattick, RP, Kimber, J, Breen, C, Davoli, M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane database of systematic reviews (Online). 2008(2):CD002207.CrossRefGoogle Scholar
44Luty, J, Nikolaou, V, Bearn, J. Is opiate detoxification unsafe in pregnancy? J Subst Abuse Treat 2003; 24: 363–67.CrossRefGoogle ScholarPubMed
45NICE. Drug misuse and dependence. UK guidelines on clinical management. London: Department of Health 2007.Google Scholar
46Burns, L, Mattick, RP, Lim, K, Wallace, C. Methadone in pregnancy: treatment retention and neonatal outcomes. Addiction 2007; 102: 264–70.CrossRefGoogle ScholarPubMed
47Jones, HE, O'Grady, KE, Malfi, D, Tuten, M. Methadone maintenance vs. methadone taper during pregnancy: maternal and neonatal outcomes. Am J Addict 2008; 17: 372–86.CrossRefGoogle ScholarPubMed
48McCarthy, JJ, Leamon, MH, Parr, MS, Anania, B. High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes. Am J Obstet Gynecol 2005; 193: 606–10.CrossRefGoogle ScholarPubMed
49Wolff, K, Boys, A, Rostami-Hodjegan, A, Hay, A, Raistrick, D. Changes to methadone clearance during pregnancy. Eur J Clin Pharmacol 2005; 61: 763–68.CrossRefGoogle ScholarPubMed
50Miles, J, Sugumar, K, Macrory, F, Sims, DG, D'Souza, SW. Methadone-exposed newborn infants: outcome after alterations to a service for mothers and infants. Child Care Health Dev 2007; 33: 206–12.CrossRefGoogle ScholarPubMed
51Minozzi, S, Amato, L, Davoli, M, Farrell, M, Lima Reisser, AA, Pani, PP et al. Anticonvulsants for cocaine dependence. Cochrane database of systematic reviews (Online). 2008(2):CD006754.CrossRefGoogle Scholar
52Lima, MS, Reisser, AA, Soares, BG, Farrell, M. Antidepressants for cocaine dependence. Cochrane database of systematic reviews (Online). 2001(4):CD002950.CrossRefGoogle Scholar
53Srisurapanont, M, Jarusuraisin, N, Kittirattanapaiboon, P. Treatment for amphetamine dependence and abuse. Cochrane database of systematic reviews (Online). 2001(4):CD003022.CrossRefGoogle Scholar
54Srisurapanont, M, Jarusuraisin, N, Kittirattanapaiboon, P. Treatment for amphetamine withdrawal. Cochrane database of systematic reviews (Online). 2001(4):CD003021.CrossRefGoogle Scholar
55Mayet, S, Farrell, M, Ferri, M, Amato, L, Davoli, M. Psychosocial treatment for opiate abuse and dependence. Cochrane database of systematic reviews (Online). 2005(1):CD004330.CrossRefGoogle Scholar
56Amato, L, Minozzi, S, Davoli, M, Vecchi, S, Ferri, MM, Mayet, S. Psychosocial combined with agonist maintenance treatments versus agonist maintenance treatments alone for treatment of opioid dependence. Cochrane database of systematic reviews (Online). 2008(4):CD004147.CrossRefGoogle Scholar
57Terplan, M, Lui, S. Psychosocial interventions for pregnant women in outpatient illicit drug treatment programs compared to other interventions. Cochrane database of systematic reviews (Online). 2007(4):CD006037.CrossRefGoogle Scholar
58Lui, S, Terplan, M, Smith, EJ. Psychosocial interventions for women enrolled in alcohol treatment during pregnancy. Cochrane database of systematic reviews (Online). 2008(3):CD006753.CrossRefGoogle Scholar
59Petry, NM. Contingency management treatments. Br J Psychiatry 2006; 189: 97–98.CrossRefGoogle ScholarPubMed
60Petry, NM, Alessi, SM, Hanson, T, Sierra, S. Randomized trial of contingent prizes versus vouchers in cocaine-using methadone patients. J Consult Clin Psychol 2007; 75: 983–91.CrossRefGoogle ScholarPubMed
61Petry, NM, Alessi, SM, Marx, J, Austin, M, Tardif, M. Vouchers versus prizes: contingency management treatment of substance abusers in community settings. J Consult Clin Psychol 2005; 73: 1005–14.CrossRefGoogle ScholarPubMed
62Prendergast, M, Podus, D, Finney, J, Greenwell, L, Roll, J. Contingency management for treatment of substance use disorders: a meta-analysis. Addiction 2006; 101: 1546–560.CrossRefGoogle ScholarPubMed
63NICE. Drug misuse: Psychosocial interventions. 2007; NICE Clinical guideline (51).Google Scholar
64Scott, J, Gilvarry, E, Farrell, M. Managing anxiety and depression in alcohol and drug dependence. Addict Behav 1998; 23: 919–31.CrossRefGoogle ScholarPubMed
65Stein, MD, Herman, DS, Solomon, DA, Anthony, JL, Anderson, BJ, Ramsey, SE, et al. Adherence to treatment of depression in active injection drug users: the minerva study. J Subst Abuse Treat 2004; 26: 87–93.CrossRefGoogle ScholarPubMed
66Lee, NK, Rawson, RA. A systematic review of cognitive and behavioural therapies for methamphetamine dependence. Drug Alcohol Rev 2008; 27: 309–17.CrossRefGoogle ScholarPubMed
67Dutra, L, Stathopoulou, G, Basden, SL, Leyro, TM, Powers, MB, Otto, MW. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry 2008; 165: 179–87.CrossRefGoogle ScholarPubMed
68Lester, BM, ElSohly, M, Wright, LL, Smeriglio, VL, Verter, J, Bauer, CR, et al. The Maternal Lifestyle Study: drug use by meconium toxicology and maternal self-report. Pediatrics 2001; 107: 309–17.CrossRefGoogle ScholarPubMed
69Department of Health. Responding to domestic abuse: A handbook for health professionals. 2005.Google Scholar
70Humphreys, C.Regan, L.River, D. TRK. Domestic Violence and substance use: Tackling complexity. Br J Soc Work 2005; 35: 1303–320.CrossRefGoogle Scholar
71Department of Health. Domestic Violence: A resource manual for health care professionals. 2000.Google Scholar
72Arlettaz, R, Kashiwagi, M, Das-Kundu, S, Fauchere, JC, Lang, A, Bucher, HU. Methadone maintenance program in pregnancy in a Swiss perinatal center (II): neonatal outcome and social resources. Acta Obstet Gynecol Scand 2005; 84: 145–50.CrossRefGoogle Scholar
73Cassidy, B, Cyna, AM. Challenges that opioid-dependent women present to the obstetric anaesthetist. Anaesth Intensive Care 2004; 32: 494–501.CrossRefGoogle Scholar
74Meyer, M, Wagner, K, Benvenuto, A, Plante, D, Howard, D. Intrapartum and postpartum analgesia for women maintained on methadone during pregnancy. Obstet Gynecol 2007; 110: 261–66.CrossRefGoogle ScholarPubMed
75Leggate, J. Improving pregnancy outcomes: mothers and substance misuse. Br J Midwifery 2008; 16: 160–65.CrossRefGoogle Scholar
76Scottish Intercollegiate Guidelines Network (SGN) Management of hepatitis C. 2006.Google Scholar
77Effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus. European Paediatric Hepatitis C Virus Network. BJOG 2001; 108: 371–77.Google Scholar
78Ballard, JL. Treatment of neonatal abstinence syndrome with breast milk containing methadone. J Perinat Neonatal Nurs 2002; 15: 76–85.CrossRefGoogle ScholarPubMed
79Begg, EJ, Malpas, TJ, Hackett, LP, Ilett, KF. Distribution of R- and S-methadone into human milk during multiple, medium to high oral dosing. Br J Clin Pharmacol 2001; 52: 681–85.CrossRefGoogle ScholarPubMed
80Fulroth, R, Phillips, B, Durand, DJ. Perinatal outcome of infants exposed to cocaine and/or heroin in utero. Am J Dis Child 1989; 143: 905–10.Google ScholarPubMed
81Lipsitz, PJ. A proposed narcotic withdrawal score for use with newborn infants. A pragmatic evaluation of its efficacy. Clin Pediatr 1975; 14: 592–94.CrossRefGoogle ScholarPubMed
82Finnegan, LP, Connaughton, JF Jr, Kron, RE, Emich, JP. Neonatal abstinence syndrome: assessment and management. Addict Dis 1975; 2: 141–58.Google ScholarPubMed
83Kuschel, C. Managing drug withdrawal in the newborn infant. Semin Fetal Neonatal Med 2007; 12: 127–33.CrossRefGoogle ScholarPubMed
84Oei, J, Lui, K. Management of the newborn infant affected by maternal opiates and other drugs of dependency. J Paediatr Child Health 2007; 43: 9–18.CrossRefGoogle ScholarPubMed