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Drugs (Birth Defect Information: Exposures and Risk Factors)

MO-10-0004 CBDMP



Approximately 4 percent of pregnant women use illicit drugs such as marijuana, cocaine, amphetamines, and heroine.1 Babies are often exposed to illicit drugs in utero due to the fact that women do not always reduce their use of drugs until pregnancy is diagnosed.2

How Do Drugs Enter the Placenta?

Most substances that a pregnant woman ingests passes freely across the placenta and into the womb. The concentration of the substance in the fetal system can be the same or even higher than in the mother. Effects from any substance on the developing embryo and fetus depend on the gestational age and the extent or amount of drugs passing into the placenta. Unfortunately, the impurity of most illicit drugs and the fact that many women use more than one, makes it difficult to identify specific effects to a certain drug.2

Possible Effects of Illicit Drugs

  • Low birth weight2, 3
  • Small head circumference2, 3
  • Prematurity2, 3
  • Cardiovascular and genitourinary problems3
  • Gastroschisis4
  • Other developmental, behavioral and cognitive problems2, 6

Why Do We Say Possible Effects?

Because of the very nature of illicit drug use, it is virtually impossible to determine with accuracy the purity, dosage and period of exposure when studying the effects of substance abuse on the fetus. Reliable data on drug use, birth outcomes, and maternal characteristics are rare.3  Furthermore, it is difficult to control for environmental factors. At this time, there is no identified birth defect syndrome associated with illicit drugs.2 In fact, the results of some studies have held that there is no relation between neural tube defects and illicit drug use.5

A Closer Look

Methamphetamine / Amphetamine / Dextroamphetamine / Ecstasy - Crank, Crystal, Meth, Speed

What is it?

Dextroamphetamine is a prescription drug that is sometimes used for ADHD, sleep disorders and as an appetite suppressant. Methamphetamines and amphetamines are occasionally prescribed by a doctor but are most often used recreationally. They act like a stimulant and gives the user a feeling of euphoria, wakefulness and suppress the appetite.10

Effects on the fetus

Low birth weight, smaller-than-normal head circumference, premature delivery, placental problems. After delivery exposed babies may experience withdrawal like symptoms which may include jitteriness, drowsiness, and breathing problems.1

Heroin - “H”, Smack, Dope, Chiba/Chiva

What is it?

Heroine is an illegal, highly addictive drug. It is and opiate that is process from morphine. Heroine is often “cut” with other substances therefore it is very difficult to know the actual dosage and/or purity of the drug.11

Effects on the fetus

Poor fetal growth, premature rupture of membranes (PROM), premature birth, and stillbirth. Heroin exposed babies often experience withdrawal symptoms after birth which can include; fever, sneezing, trembling, irritability, diarrhea, vomiting, continual crying, seizures, and an increased risk of sudden infant death syndrome (SIDS).1

Cocaine - Blow, Coke

What is it?

Originally used as an anesthetic, cocaine is a highly addictive stimulant of the central nervous system when used recreationally.7, 8

Effects on the fetus

When a pregnant woman uses cocaine the drug easily crosses the placenta and enters the baby’s circulation where the elimination process is much slower. Cocaine therefore remains in a baby’s body much longer than it does the mothers.8 If taken during the beginning of pregnancy, it may increase the risk of  miscarriage.1 If taken at other times during pregnancy; cocaine may increase the risk of preterm labor, poor fetal growth, smaller-than-normal head circumference. Use may also put babies at increased risk of birth defects involving the brain, skull, face, eyes, heart, limbs, intestines, genitals and urinary tract.8 After delivery cocaine exposed babies may experience withdrawal like symptoms which may include jitteriness, irritability, startle easy, and  sleepiness.1

Marijuana - Pot, Weed

What is it?

A recreational drug that comes from the hemp plant which is most often smoked causing euphoric effects. Some states allow prescriptions for marijuana usage for medical purposes.9

Effects on the fetus

Research on the affects of marijuana use during pregnancy has been inconsistent because it is difficult to obtain accurate information on the amount, frequency, timing and purity. Symptoms include slow fetal growth, risk of premature delivery, withdrawal like symptoms after delivery which may include excessive crying and trembling.1

What You Can Do?

Research has found that even minimal drug interventions, along with counseling and consistent prenatal care can lead to better birth outcomes for fetuses exposed in utero to illicit substances.2 It is very important that a woman who decides to stop using drugs during pregnancy seek medical help. Some illegal drugs can cause fetal death if stopped abruptly.1

Additional Resources

National Council on Alcoholism and Drug Dependence (NCADD)

National Institute on Drug Abuse (NIDA)

Narcotics Anonymous

Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment


  1. http://www.marchofdimes.com/professionals/14332_1169.asp
  2. Rayburn, W. F. (2007).Maternal and fetal effects from substance use. Clinics in Perinatology. 34, 559-571. 
  3. Noonan, K., Reichman, N. E., Corman, H., & Dave, D (2007). Prenatal drug use and the production of infant health. Health Economics, 16, 361-384. 
  4. Draper, E. S., Rankin, J., Tonks, A. M., Abrams, K. R., Field, D. J., Clarke, M., & Kurinczuk, J.J. (2007). Recreational drug use: a major risk factor for gastroschisis. 167, 485-491. 
  5. Suarez, L., Felkner, M., Brender, J.D., Canfield, M., & Hendricks, K. (2007). Maternal exposures to cigarette smoke, alcohol, and street drugs and neural tube defect occurrence in offspring. Maternal and Child Health Journal. 12, 394-401.
  6. (2009, February 13). Medical consequences of drug abuse. Retrieved May 29, 2009, from National Institute on Drug Abuse Web site: http://www.drugabuse.gov/consequences/prenatal 
  7. http://www.yourdictionary.com/cocaine
  8. (2001, August). Cocaine and pregnancy. Retrieved June 16, 2009, from Organization of Teratology Information Specialists Web site: http://www.otispregnancy.org/pdf/cocaine
  9. (2007, April). Marijuana and pregnancy. Retrieved June 16, 2009, from Organization of Teratology Information Specialists Web site: http://www.otispregnancy.org/pdf/marijuana
  10. http://en.wikipedia.org/wiki/Amphetamine
  11. http://www.drugabuse.gov/ResearchReports/Heroin/heroin2.html#what
Last modified on: 8/5/2010 8:00 AM