Substance abuse in pregnancy – Related resources

Cochrane reviews

• There is insufficient evidence of psychological and educational interventions for reducing alcohol consumption in pregnant women . ."?>
• There is insufficient evidence of the effectiveness of psychosocial interventions on illicit drug use in pregnant women or obstetrical or neonatal outcomes. Contingency management strategies seem to improve retention in treatment programs .
• There is insufficient evidence on benefits of naloxone to newborn infants with cardiorespiratory or neurological depression due to intrauterine exposure to opiate.
• Opiates, as compared to supportive care only, appear to reduce the time to regain birth weight and reduce the duration of supportive care, but increase the duration of hospital stay in the treatment of neonatal abstinence syndrome due to withdrawal from opiates .
• In newborn infants with neonatal abstinence syndrome (NAS) needing a sedative, phenobarbital may reduce the daily duration of supportive care needed, and compared to diazepam may reduce treatment failure. An opiate is the preferred initial therapy for NAS .
• Routine home visits after childbirth for women with a drug or alcohol problem may not be helpful in solving the abuse problem .

Literature

• American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women. Committee Opinion No. 479: Methamphetamine abuse in women of reproductive age. Obstet Gynecol 2011;117(3):751-5.
• American College of Obstetricians and Gynecologists. Committee on Health Care for Underserved Women. Committee opinion no. 496: At-risk drinking and alcohol dependence: obstetric and gynecologic implications. Obstet Gynecol 2011;118(2 Pt 1):383-8.
• Patra J, Bakker R, Irving H et al. Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG 2011;118(12):1411-21.
• Carson G, Cox LV, Crane J et al. Alcohol use and pregnancy consensus clinical guidelines. J Obstet Gynaecol Can 2010;32(8 Suppl 3):S1-31.
• English DR, Hulse GK, Milne E et al. Maternal cannabis use and birth weight: a meta-analysis. Addiction 1997;92(11):1553-60.
• Hall W, Degenhardt L. Adverse health effects of non-medical cannabis use. Lancet 2009;374(9698):1383-91.
• Holmes LB. 2011. Human Teratogens: Update 2010. Birth Defects Research Part A: Clinical and Molecular Teratology, vol. 91, no. 1, pp. 1-7 ISSN 1542-0760. DOI 10.1002/bdra.20748.
• Minozzi S, Amato L, Vecchi S et al. Maintenance agonist treatments for opiate dependent pregnant women. Cochrane Database Syst Rev 2008;(2):CD006318.
• Reece AS. Chronic toxicology of cannabis. Clin Toxicol (Phila) 2009;47(6):517-24.
• Wong S, Ordean A, Kahan M et al. SOGC clinical practice guidelines: Substance use in pregnancy: no. 256, April 2011. Int J Gynaecol Obstet 2011;114(2):190-202.
• Bell J, Harvey-Dodds L. Pregnancy and injecting drug use. BMJ 2008 Jun 7;336(7656):1303-5.
• Kahila H, Saisto T, Kivitie-Kallio S, Haukkamaa M, Halmesmäki E. A prospective study on buprenorphine use during pregnancy: effects on maternal and neonatal outcome. Acta Obstet Gynecol Scand 2007;86(2):185-90.
• Kahila H, Kivitie-Kallio S, Halmesmäki E, Valanne L, Autti T. Brain magnetic resonance imaging of infants exposed prenatally to buprenorphine. Acta Radiol 2007 Mar;48(2):228-31.
• Sarkola T, Kahila H, Gissler M, Halmesmäki E. Risk factors for out-of-home custody child care among families with alcohol and substance abuse problems. Acta Paediatr 2007 Nov;96(11):1571-6.
• Hytinantti T, Kahila H, Renlund M, Järvenpää AL, Halmesmäki E, Kivitie-Kallio S. Neonatal outcome of 58 infants exposed to maternal buprenorphine in utero. Acta Paediatr 2008 Aug;97(8):1040-4.
• Kahila H, Stefanovic V, Loukovaara M, Alfthan H, Hämäläinen E, Halmesmäki E. Prenatal buprenorphine exposure: effects on biochemical markers of hypoxia and early neonatal outcome. Acta Obstet Gynecol Scand 2008;87(11):1213-9.