Abstract
Substance use disorders are among the most complex, stigmatized and poorly understood medical conditions affecting pregnant and postpartum individuals. In this chapter, we provide a comprehensive review of substance use and addiction prevalence in the United States. Sex and gender considerations and the unique vulnerabilities of the peripartum period, specifically the role of substance use in maternal death, are addressed. We review six substance classes: tobacco, alcohol, cannabis, opioids, stimulants, and benzodiazepines. For each, the prevalence; pharmacology; screening; maternal, fetal, and neonatal/child effects; and treatment recommendations are discussed. We conclude by reviewing current research and clinical practice gaps and make suggestions for future research.
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