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Sonia Gutierrez
Professor Ibarra
HLTH 1050-004
4 November 2016
Prenatal Exposure to Drugs and Alcohol
On a crisp autumn day, a woman arrives at a hospital to give birth to her child. She has a
difficult and complicated birth. The newborn is small, smaller than she should be at 8 months.
After giving birth, the mother shows no interest in the child, all she wants is prescription pain
medication because she says she cant handle the pain. After the baby has been cleaned and
swaddled the nurses begin to notice some problems. The baby cant stop crying and she is
twitching uncontrollably. The medical staff soon come to find out that the mother is a drug addict
and used heroin, among other drugs, throughout her pregnancy. Child Services comes to remove
the child from the mothers custody to protect her from future harm, but its too late. The damage
has been done. The child has suffered irreversible brain damage from the drug and is currently
going through the same painful withdrawals that an adult drug addict goes through. Her life will
be difficult as she will have mental, emotional and physical problems for the rest of her life, if
she can survive the next few weeks.
This particular story is fictional, but unfortunately, it is the real story of many children
born to drug addicted mothers. From meth, to marijuana, to smoking and alcohol, this paper will
explain the effects of these drugs and more on infants. The overall effects, though, are

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astoundingly negative. Creating problems from the beginning of an infant's life to his or her
relationships and work life later on in adulthood.
According to the textbook Drugs, Behavior, and Modern Society, Levinthal states that
during a pregnancy more than 26% of mothers smoked cigarettes, 18% consumed alcohol and
8% smoked marijuana (43). Unfortunately, if a pregnant woman is using drugs it is common for
her to be using more than one drug as well. Other problems that accompany multi-drug use
include, lack of prenatal care, high rates of violence exposure, co-occurrence of other
psychiatric problems, inadequate nutrition, and poverty (Jones 127). Because of this, it is
difficult to isolate the effects of individual drugs.
The amount of damage that a drug can cause on a developing fetus depends heavily on
the time that it was introduced. A pregnancy is divided into three trimesters. The first trimester is
from the moment of conception to twelve weeks of gestation, the second trimester is from
thirteen to twenty-eight weeks and the final third trimester is from twenty-nine to forty weeks. A
fetus is more susceptible to be harmed during the first trimester as using drugs, during the early
weeks of pregnancy, from the fourth to the eighth week following conception, is more likely to
increase the risks of spontaneous abortions and physical malformations in the newborn than drug
use later in the pregnancy (Levinthal 43).
Many drugs such as alcohol, heroin, and other opiates create withdrawal symptoms, also
known as Neonatal Abstinence Syndrome, since the child becomes dependent on the drugs.
These symptoms can include: diarrhea, excessive crying, fever, irritability, seizures, sleep
problems, trembling and vomiting and is very painful for the child (Lee). Just like an adult goes
through withdrawal, so does a child and depending on the drug and quantity used, it can be more
or less severe. The amount of drugs in the infants system is disproportionately larger than that of

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the mothers. The same amount of drugs that are pumping through an adult woman are pumping
through a baby who hasnt yet developed the capacity to process and get rid of the drugs.
Approximately, 17 % women abusers in the USA were primary [Methamphetamine]
users, but 38 % had used it during pregnancy (Marwick). Methamphetamine (MA) is one of the
drugs that many women use along with other drugs and, therefore, create many different factors
that can influence an infants development. Because of this, the effects of MA on a developing
fetus are still not completely known and more research needs to be completed.
Some research on amphetamine, such as Adderall and Ritalin, and MA use, however, has
found links with many physical malformations and defects and withdrawal effects. Some of the
associated defects include low birth weight, heart defects, cleft lip, small head circumference,
and brain hemorrhage. Possible behavioral effects include tremor, irritability, impaired ability to
deal with stress and irregular sleep (lamberov S127). Complications during pregnancy also
seem to be higher with the risk of high blood pressure and placental abruption, where the
placenta separates from the lining of the uterus, being linked with amphetamine use (Moore 76).
However, very little studies exist that account for all the variable and it is not possible to be
certain that all of these effects are associated with this specific drug at this time (Jones 127).
According to a study by Singer et al (Prenatal Ecstasy Exposure 292), the use of
ecstasy and MDMA during pregnancy doesnt have any significant cognitive effects but it does
lead to decreased motor skills, both gross and fine. The study found that these effects were most
likely caused by MDMA use during the first trimester and the effects were not observed until the
exposed infant was 12 months old, with the decreased motor skills even more pronounced at 24
months (292).

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The effects of the drug itself are not what cause the decreased motor skills but the
increased cortisol, a natural and necessary stress hormone, in the mothers body. It is not harmful
in normal quantities, but increased levels are, associated with several adverse physical effects,
including low birth-weight, reduced head circumference, low Agpar[sic] scores and other shortterm/long-term developmental issues such as decreased attention, irritability, problems sleeping
and feeding (Parrott et al 4). For every 10% increase of cortisol level that a mother has, the
fetuss level will increase by 1%. MDMA increases cortisol levels by 800% within four hours of
using, thus increasing the chance of harming the fetus with an 80% increase, and 40% increase
for the next three months (5).
Infants exposed to cocaine since birth, commonly known as crack babies, experience
many detrimental effects from birth to adulthood. The problem of multiple drugs used
throughout pregnancy is also present adding to the risk of affecting the infant. According to
Singer, prenatal cocaine exposure had significant effects on the child ranging from, low to
moderate effects on fetal growth, attention, language, visualmotor perceptual organization, ...,
[and] externalizing behavior problems (Prenatal Cocaine Exposure 288). At birth they show
signs of addiction, low birth weight and length and small head circumference. Jitteriness, short
attention span and decreased motor abilities were also found. These problems also follow
children and escalate as they grow; children exposed to cocaine show lower IQ scores by the age
of 9, decreased attention spans, decreased ability to make executive decisions and an increased
chance of abusing drugs themselves (286-287).
The effects of opioids such as morphine and heroin on a fetus are similar to those of
cocaine and methamphetamine with smaller head circumference and lower birth weight present
(lamberov S125). Opioid exposure also increased the quantity of opioid receptors in the

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nucleus accumbens of mice, making them more like to become addicted to drugs (S126). Based
on further studies on mice, opioids increase the chances of a stillborn child, decreased weight
gain, and decreased cognitive functions such as memory and learning (S125-126). Studies about
treating an addiction with methadone treatment while pregnant, however, show that it produces
similar effects to those of opioids (S130).
More women smoke tobacco while pregnant than use other drugs, making the effects of
nicotine and tobacco more common. A report on prenatal smoking in Europe stated that in 2010,
over 10% of women reported smoking during the last trimester of their pregnancy (Tiesler 915).
Cigarettes contain many known carcinogens that increase the chances of the smoker to develop
cardiovascular diseases, lung problems, and many kinds of cancer. The chances also increase for
the developing fetus to be harmed by these dangerous chemicals.
Smoking creates a host of problems both for the fetus and for the mother. Birth weight
decreases, smaller head size, and the risk for complications during pregnancy and delivery
increases (916). Exposure to nicotine has also been linked to problems with an infant's
respiratory system such as asthma and an increased risk for Sudden Infant Death Syndrome, the
mysterious cause of death for sleeping infants less than one year of age(916). There is also a link
between nicotine and tobacco smoke exposure and the increased risk for ADHD and conduct
problems as the infant grows (917). Second hand smoke also has the potential to harm a fetus,
even if the mother doesnt smoke.
The effects of alcohol on infants have been studied and documented since its discovery. It
was previously believed that drinking alcohol did not harm a baby before it was born. This was
because it was believed that the placenta acted as a filter that didnt allow alcohol to pass into the
bloodstream of the fetus. That later changed to belief that small amounts of alcohol consumption

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wouldnt harm the fetus. That fact has changed once again with research being done on the
subject since the 1970s.
Fetal Alcohol Syndrome, or FAS, is a very real and encompasses all of the very
debilitating effects caused by the consumption of alcohol during pregnancy. The more alcohol
consumed, the greater the effects on the infant. The same can be said about the stage of
pregnancy, the earlier alcohol is the more consequences it has. According to Levinthal, FAS is,
the third leading cause of mental retardation not only in the United States but in the entire
Western World (Levinthal 230). The effects of FAS can include decreased birth weight,
decreased weight gain, abnormalities with brain development and cognition, physical
malformations of the skull and face (229). If only some of the symptoms are observed, it is
called Fetal Alcohol Effect. The level of damage to the infant that alcohol causes is related to the
amount consumed and timing during pregnancy.
In total, drug consumption during a pregnancy creates a plethora of problems for both the
mother and child. However an infant has no say in what happens to it and has to suffer the
consequences of the mothers choice to abuse drugs. Prenatal exposure to drugs creates problems
for the infant not just at birth but also later in life and development. Drug use throughout at a
pregnancy seems to decrease as the pregnancy goes on, but more must be done to prevent the
unnecessary exposure of drugs for many infants.

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Works Cited
Jones, Hendree E. "Drug Addiction During Pregnancy". Current Directions in Psychological
Science 15.3 (2006): 126-130. Web. 26 Oct. 2016.
Lee, Kimberly G. "Neonatal Abstinence Syndrome". Medlineplus.gov. N.p., 2016. Web. 30 Nov.
2016.
Levinthal, Charles F. Drugs, Behavior, And Modern Society. 8th ed. Pearson, 2014. Print.
Marwick, Charles. "NIDA Seeking Data On Effect Of Fetal Exposure To Methamphetamine".
JAMA 283.17 (2000): 2225-2226. Web. 22 Nov. 2016.
Moore, Shelley C. "Adderall And Ritalin: Potential Influence On Perinatal Health." International
Journal Of Childbirth Education 29.4 (2014): 72-78. CINAHL Complete. Web. 23 Nov.
2016.
Parrott, Andrew C. et al. "MDMA And Heightened Cortisol: A Neurohormonal Perspective On
The Pregnancy Outcomes Of Mothers Used Ecstasy During Pregnancy". Human
Psychopharmacology: Clinical and Experimental 29.1 (2014): 1-7. Web. 23 Nov. 2016.
Singer, Lynn T. et al. "Developmental Outcomes Of 3,4-Methylenedioxymethamphetamine
(Ecstasy)-Exposed Infants In The UK". Human Psychopharmacology: Clinical and
Experimental 30.4 (2015): 290-294. Web. 23 Nov. 2016.
Singer, Lynn T. et al. "Prenatal Cocaine Exposure And Child Outcomes: A Conference Report
Based On A Prospective Study From Cleveland". Human Psychopharmacology: Clinical
and Experimental 30.4 (2015): 285-289. Web. 28 Nov. 2016.
lamberov, R. "Drugs In Pregnancy: The Effects On Mother And Her Progeny."
Physiological Research 62.(2012): S123-S135. CINAHL Complete. Web. 22 Nov. 2016.
Tiesler, Carla M. T. and Joachim Heinrich. "Prenatal Nicotine Exposure And Child Behavioural

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Problems". European Child & Adolescent Psychiatry 23.10 (2014): 913-929. Web. 30
Nov. 2016.