Addictive Disorders in Women: The Impact of Maternal Substance Use on the Fetus and Newborn

Abstract

Addictive disorders are rising to epidemic proportions throughout the United States and globally, placing significant social and economic burdens on industrialized societies. It is well-known that a high percentage of drug-dependent individuals are women of childbearing age. Maternal substance use and abuse exposes the fetus to drugs of dependence during critical periods of development, resulting in short- and long-term neurodevelopmental effects in infancy and childhood. Neonatal abstinence syndrome (NAS) is a term that was initially used to describe the withdrawal symptoms observed in infants who were exposed to opioids in utero. As we have learned more about the various effects of in utero drug exposure and the subsequent consequences, NAS has become a term that more broadly describes the signs and symptoms of withdrawal resulting from any dependence-inducing substance consumed by a pregnant woman. The aim of this review is to discuss the perinatal outcome of pregnancy associated with maternal drug use. In the United States and other developed nations, the incidence of NAS continues to rise, paralleling the evolution of the opioid epidemic. Chronic in utero exposures to licit and illicit drugs of dependence have fetal, neonatal, and early childhood consequences and are addressed in this review.