The use of psychotropic substances during pregnancy has the potential to cause harm to the developing fetus. Each substance carries specific and often dose dependent effects. It is important to establish the type of substance used, the last time the substance was consumed, as well as the frequency and pattern of use. Care is best delivered through a multi-professional team with prompt interdisciplinary and inter-agency communication. Any co-existing physical or mental health needs should be addressed alongside the woman's substance misuse. Post-delivery, the risk of opiate withdrawal for mother and baby is of concern. Longer term infant outcomes following the use of psychotropic drugs include cognitive impairment and developmental delay. The combination of a hectic, unpredictable lifestyle, financial constraints and lack of support associated with substance misuse makes optimising care a real challenge. Neonatal and maternal outcomes can be optimised when women engage with maternity and drug and alcohol services.
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