Clinical Background
Exposure to maternal drug abuse during gestation may adversely affect neonatal development in addition to long-term childhood and adult outcomes.
Cocaine use associated with
- Irritability and withdrawal at birth
- Subarachnoid and intracerebral hemorrhage
- Premature labor
- Small neonatal head size
- Reduced birth weight
- Ruptured uterus
- Fetal death
- Childhood and adult behavioral disorders (Attention Deficit Hyperactivity Disorder - ADHD)
Amphetamines (particularly methamphetamine) use associated with
- Effects that are similar to cocaine (both are central nervous system stimulants)
- Complications during pregnancy
- Increased rates of premature birth
- Medical problems in early life
Cannabinoid (marijuana) use associated with
- Negative effect on attentional behavior and on visual analysis/hypothesis testing
- No effect on global IQ
Opiates, methadone, propoxyphene, barbiturates and benzodiazepines use associated with
- Withdrawal symptoms
- Irritability
- Tremors
- Hyperactivity
- Seizures
Meconium (the dark, tarry material passed from the rectum in the first days after birth until milk or formula-based stool appears) is the specimen of choice for assessing in utero exposure of the neonate to maternal drug abuse.
- Meconium is preferred over urine for testing.
- Meconium documents multiple use over an extended period of time, covering the last 4-5 months of pregnancy
- Urine testing can only indicate drug use over the last 1-10 days, depending on the drug
- Meconium is easier to obtain than urine (combining all meconium voids can be helpful if sample size is small)
See Also
