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Prenatal Exposure to
Drugs and Their Consequences

Certain legal and illegal drugs used during pregnancy may interfere with the development of the foetus, and or result in complications during and after childbirth.   Drug use during pregnancy is generally associated with low birth weight infants and premature births.  These factors are associated with higher child abuse, neglect and child homicides as compared to the general population.

Serious or recurrent illnesses increases a child's likelihood of experiencing child abuse.

However, the effects and their severity depend on the frequency, dosage, genetic metabolism of the parent and foetus and the type(s) of drugs used during the gestation period.

This table below and associated links may help determine possible risks associate with use of drugs during pregnancy.


Summary of main harms

Some of the harms resulting to children from different types of substances used during pregnancy include:

bullet amphetamines, marijuana, benzodiazepines, nicotine and prescribed drugs have been shown to harm the foetus
bullet alcohol is connected with mental retardation, abnormalities of the central nervous system such as microcephaly, poor coordination, irritability in infancy, hyperactivity in childhood, growth deficiency and cranio-facial abnormalities
bullet methadone causes low birth weight, addiction and withdrawal symptoms. Supervised methadone in women receiving adequate prenatal care decreases the incidence of neonatal complications and deaths (but not withdrawal symptoms).


Class of Drugs Possible Perinatal Effects on Children Possible Long Term Effects on Children
Possible Symptoms

Excessively sleepy, rarely cry, feeding may be poor requiring tube feeding

Foetal distress

Intrauterine growth retardation

Decrease in head circumference

In one-third of full term, evidence of brain haemorrhage, cavitation or infarction

Possible Effects

Increased incidences of aggressive behaviours

Peer related problems


Prenatal damage cannot be fully compensated for by good psychosocial environments after birth


Possible Symptoms

Foetal Alcohol Effects and Foetal Alcohol Syndrome: 1-3 per 1,000 births

Growth failure, facial abnormalities and abnormalities of the heart, kidneys, ears and skeletal system

Hearing loss and chronic inflammation of ear

Average IQ of 63 but wide ranging

Symptoms of withdrawal have occurred in neonates who mothers continued to drink throughout pregnancy

FAS - include palpebral fissures, short upturned nose, hypoplastic philtrum (depression between nose and upper lip), flat midface and thinned upper lip.

Possible Effects

Improvement of dysmorphic features over time

High level of psychosocial problems, i.e. learning disabilities, hyperactivity, impulsivity, and antisocial behaviour

Growth failure and mental retardation are not ameliorated even if the children are reared in positive environment

Average academic functioning at the second to fourth grade levels, with a significant deficit in arithmetic skills. Poor independent living skills, judgements

Maladaptive behaviours such as destructibility and difficulty perceiving social cues


Class of Drugs Possible Perinatal Effects on Children Possible Long Term Effects on Children
(Depressant with some Stimulant and Hallucinogenic effects)
Possible Symptoms

Higher risk of pre-term, low birthweight or small for gestational age infant (may be primarily related to tobacco and other drug use)

Possible Effects

Signs of some irritability

Signs of optical blink, strabismus

Research continuing


Possible Symptoms

Intrauterine growth retarded, small head circumference

Withdrawal symptoms (after a few days)

Cardiac, urinary tract defects

Neurobehavioural effects

Poor social interaction

Sleep poorly

Poor feeding

Possible Effects

Delays in fine motor and visual coordination


Persistent irritability

Difficulty sitting balanced

Central nervous system damage

Immune system damage

Class of Drugs Possible Perinatal Effects on Children Possible Long Term Effects on Children
(Depressant with some hallucinatory properties)

Glue, Solvents, Petrol, Aerosol, Toluene, Nitrous Oxide

Possible Symptoms

May have similar effects to alcohol

Lead in petrol affects brain functioning

Difficult to separate effects as often used with other substances

Some likely to be more hazardous that others (eg leaded petrol more hazardous than glue. Nitrous Oxide less hazardous than glue)

Possible Effects


Possible Symptoms

May be born addicted to opiates

Withdrawal symptoms (birth to 4 months but most symptoms over in one to two weeks): extreme reflex reactions, tremors, irritability, abnormal crying disturbed sleep and impaired motor control

Possible Effects

Few if any long term-effects.

Initial symptoms may interfere with bonding which can have a range of long-term effects.

Adapted from Department of Community Services
Alcohol and Other DrugsL Issues for Child Protection Risk Assessment Training Package, April, 1999

Internet Links 

 Alcohol, Other Drugs and Pregnancy
Comprehensive & easy to use: ADF web TRANX Steering Committee - Victoria

Alcohol & Pregnancy
WA Health Department

Drugs in Pregnancy and Lactation
Comprehensive alphabetical listing of effects of prescribed drugs in-utero and in breast milk

Drugs in Pregnancy and Lactation
Similar to the above site but contains two simple, printable pages: Drugs you can use and Drugs you should stop

Drugs in Pregnancy
Safer drug choices are provided for commonly occurring conditions in pregnancy

Policy Statement: Women, Alcohol, Other Drugs and Pregnancy
Well balance policy approach to AOD use and pregnancy from the USA National Council on Alcoholism and Drug Dependence

Drug Use During Pregnancy (Merck Manual)
High Risk Pregnancy (Merck Manual)

Medical overview of drug effects on pregnancy. Comprehensive risk factors and drug information  

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