Drug exposure and intrauterine growth

Abstract

The effects of prenatal drug exposure on intrauterine growth restriction are widely acknowledged. Prevalence rates of drug-abusing women who are of reproductive age are of concern worldwide. This chapter summarizes what is known regarding the impact of prenatal exposure to various illicit and legal drugs on intrauterine growth. Brief descriptions of the drugs and the mechanisms which impact growth are also discussed. Decreased birth weight, height and head circumference, as well as increased incidence of prematurity and small for gestational age are common findings in infants who were prenatally exposed to cocaine, methamphetamines, opiates, methadone, buprenorphine, marijuana, alcohol, and nicotine. However, the studies reviewed vary in sample size and characteristics, measures used to confirm drug use, study design, and whether or not they control for potential confounders. A major design flaw in many studies is the lack of control for polydrug use. Though some studies have found no effects of prenatal drug exposure, these results should not diminish the importance of educating females regarding the potentially harmful effects of drug use during pregnancy and for continued efforts to identify optimal treatment therapies for drug-dependent pregnant and parenting women.