Drug-Exposed Infants

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Abstract
Recent studies have documented that an increasing number of women of childbearing age are abusing licit and illicit substances. Although statistical data are insufficient, there are indications that approximately 1 in 10 infants may be exposed to illicit drugs during pregnancy. The National Institute on Drug Abuse 1988 National Household Survey1 revealed that 8.8% of women of childbearing age admitted to having used an illicit drug in the month before questioning. A recent survey of 36 private and public hospitals2 showed that approximately 11% of women delivering in these hospitals had used illegal drugs at some time during their pregnancies. A preliminary study in Pinellas County, Florida, demonstrated that cocaine and marijuana use during pregnancy were almost equally distributed across racial and socioeconomic lines.3 These incidence data parallel the increasing number of infants being admitted to special-care nurseries for complications caused by their intrauterine exposure to alcohol and other drugs. It is also important to consider that drug-exposed infants often go unrecognized and are discharged from the newborn nursery to homes where they are at increased risk for a complex of medical and social problems including abuse and neglect. This statement addresses illicit substance use in pregnancy and its medical, social, mental health, and legal consequences for children and families. The Academy is developing a separate statement to address the issue of infants exposed to alcohol in utero. THE PROBLEM All illicit drugs reach the fetal circulation by crossing the placenta and can cause direct toxic effects on the fetus, as well as fetal and maternal dependency.

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