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Cocaine Use During Pregnancy

Cocaine usage during pregnancy has the potential to harm both mother and baby, and the effects may be long-lasting.

According to the 2015 National Survey on Drug Use and Health (NSDUH), roughly 1,000 pregnant women reported using cocaine in the past month 1. This usage is especially prevalent among young adults aged 18 to 25. In fact, according to a national survey, 1.7% of young adults between the ages of 18 to 25 admitted to using the drug in 2015 2.  In the United States, roughly half of all pregnancies are unplanned, and among women 19 years or younger, more than 4 out of 5 pregnancies are unintended 3. This means that a mother may use the drug before she even knows she is pregnant—placing the fetus at risk for exposure to the drug. In fact, women who use cocaine may have irregular menstrual cycles, which can delay the awareness of pregnancy 4.

Exposing a fetus to cocaine may lead to long-term health consequences, such as behavioral  problems and impaired language development. Prenatal exposure to the drug also increases the risk of adverse cognitive and neurodevelopmental issues in the baby 5.

Effects of Cocaine Use on an Expectant Mother

A pregnant woman’s health in large part shapes the health of her unborn child. Maternal cocaine abuse is associated with poverty, poor nutrition, and poor prenatal care, and due to the effects of the drug and the associated inadequate intake of healthy foods, it is common for users to have vitamin deficiencies 4—all of which may negatively affect the child in various ways.

Using substances like cocaine during pregnancy may also impact a mother’s likelihood of carrying her baby to full-term 5. “Full-term” is defined as birth between 37 and 41 weeks. The last few weeks of pregnancy are important stages in a baby’s brain development; a baby’s brain at 35 weeks is only two-thirds the weight of what it will be at 39 or 40 weeks 4. A shorter pregnancy could negatively affect a baby’s final growth spurt.

Video: Why Is Carrying to Full-Term So Important?


Credit: National Institute of Child Health and Human Development

The abuse of cocaine is also associated with a number of health issues for the mother that include psychiatric health issues, cardiovascular disease, respiratory problems, and blood-borne infections like hepatitis and HIV 2.

Other serious maternal health risks that may subsequently place the unborn baby in danger include the following 6:

  • Acute pulmonary edema.
  • Cardiac arrhythmia.
  • Increased blood pressure.
  • Seizures.
  • Sudden death.

Treatment is the best investment you can make for your health and the health of your family. If you or someone you know is pregnant and unable to stop using cocaine, give us a call today at 1-800-980-3927   . You can speak to a rehab placement specialist any time of day or night to learn about available recovery options.

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Effects on Pregnancy

Maternal cocaine use has been associated with poor outcomes during pregnancy. Problems that may arise as a result of this drug’s use within and around this delicate period include 5,7,8:

  • Problems associated with the placenta, including:
    • Placental abruption (separation of the placenta from the uterine wall).
    • Placental infarction (interruption of blood flow to the placenta).
    • Preeclampsia.
  • Impaired fetal growth:
    • Intrauterine growth restriction.
    • Low birth weight.
    • Small size for gestational age.
  • Ectopic pregnancy.
  • Spontaneous abortion.
  • Miscarriage.
  • Premature rupture of membranes.
  • Premature birth*.
  • Perinatal cerebral infarction.
  • Reduced head circumference.
  • Congenital malformations.
  • Stillbirth**.
  • Sudden infant death syndrome (SIDS).

*According to the World Health Organization (WHO), preterm birth is defined as a birth that takes place before 37 weeks of pregnancy. Preterm birth is the most common cause of death among children under 5 years of age, and many preterm children suffer from lifelong learning disabilities, as well as visual and hearing problems 9.

**One study of blood test results found that the use of a stimulant like cocaine was associated with 2.2 times greater risk of stillbirth 7. The trauma of experiencing a stillbirth can have long-term psychological effects on a mother and the family. Studies have noted that the maternal experience after stillbirth may be characterized by depression, post-traumatic stress disorder (PTSD), maternal anxiety, and unresolved mourning 10.

Prenatal Exposure and Miscarriage

The most common adverse outcome of pregnancy is a miscarriage (spontaneous abortion).  A number of studies have found that pregnant mothers who abuse cocaine are at risk for miscarriage due to the fact that usage in early pregnancy decreases blood flow 11. However, in the medical community, this remains controversial. In a meta-analysis of 20 scientific papers on substance use and pregnancy, researchers found that mothers who used it along with other drugs had an increased risk of miscarriage compared to drug-free mothers. However, when comparing women who only used cocaine with drug-free mothers, the effect was no longer present 5.

While the aforementioned studies examining cocaine and miscarriage show somewhat mixed results 12, the other potential risks introduced throughout pregnancy—such as those associated with placental problems—underscore an undeniable connection between maternal use and fetal endangerment.

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Effects on a Developing Child

One study found that children who were exposed to cocaine before birth had 2.8 times the risk of having a learning disability 13.

Cocaine affects the central nervous system (CNS). It is small in molecular weight and can cross the placenta, directly reaching the fetus. The direct impact of the drug on a developing fetus may lead to a number of congenital abnormalities (or birth defects), including 13:

  • Limb reduction defects (a limb fails to form properly).
  • Congenital heart diseases (CHDs).
  • Cleft palate.

Cocaine in utero may also cause neurodevelopmental problems for offspring, potentially contributing to 5,13:

  • Impaired adolescent functioning (poor school performance, behavior, brain structure).
  • Impaired perceptual reasoning and procedural learning.
  • Behavior problems.
  • Symptoms of oppositional defiant disorder.
  • Attention deficit hyperactivity disorder (ADHD).
  • Impaired memory and executive function.
  • Problems with language development.

Research has also found that using stimulant drugs, such as amphetamines and cocaine, is associated with increased odds of physical abuse of the child 14. This may be due to the fact that these drugs cause significant mental disturbances 14.

Researchers have also found that teens who were exposed to the drug in utero were twice as likely to use tobacco and marijuana at age 15 and to develop a substance use disorder at age compared to teens who did not experience in-utero cocaine exposure 17. These teens were also more likely to have 17:

  • Trouble problem-solving.
  • Less control over their emotions.
  • Difficulty handling stress.

If the child was mistreated, for example neglected or emotionally or physically abused, they were also more likely to suffer from the problems above. Researchers suggest that prenatal cocaine exposure may lower a child’s threshold for when they activate their stress circuits and may make them more vulnerable to stresses in their environment, including any mistreatment 17.

Teens exposed to the drug in-utero were also more likely to engage in aggressive behaviors at school, as well as steal or use tobacco or alcohol 17.

Long-term drug abuse can greatly impact the development of a child. Prenatally exposed children may be negatively impacted by living with a parent who is living in the ‘‘stress and chaos’’ of drug abuse. After a baby is born, their environment can play a major role in how they develop. If a child is raised in a stressful environment, it can decrease their chances of overcoming the effects of prenatal exposure to cocaine 15.

Getting Help for Cocaine Addiction

If you are abusing cocaine during your pregnancy, it is important that you seek medical care for your addiction. There is evidence that an early intervention can make a big difference in your child’s life.

Getting help for an addiction to this drug can greatly boost the health of your entire family in numerous ways and reduce the incidence of 16:

  • Postnatal drug exposure.
  • Chaotic lifestyles with rotating caregivers.
  • Ongoing paternal drug use.
  • Maternal depression.

There are a variety of treatment options available to help you stop using the drug and learn coping skills. Often, a parent who abuses illicit drugs like cocaine does so in order to cope with underlying stressors, such aspast trauma or abuse. Treatment can help you learn skills to help cope with these triggers without the use of cocaine or other drugs. Options for addiction treatment include:

  • Outpatient drug treatment: This option typically requires 8-12 hours a week of time spent visiting the treatment center. Treatment will consist of sessions on drug abuse education, individual and group counseling, and coping skills.
  • Inpatient drug treatment: This is a more intensive option with centers that offer 24/7 care and support. There are varying types of inpatient treatment that range from short-term stays to longer stays (30-90+ days).
  • Group-based therapy: Therapy provides you with the opportunity to learn about addiction so that you can better understand your addiction and ways to overcome it. In a group setting, you can learn and support others who are recovering from an addiction to cocaine. Group therapy is a common treatment approach offered in both outpatient and inpatient recovery programs.

By taking the steps to get treatment, you are creating a safe and healthy environment for your child. Research shows a positive association between mothers receiving drug treatment and 16:

  • Decreased substance use.
  • Reduced mental health symptoms.
  • Improved birth outcomes.
  • Employment.
  • Self-reported health status.
  • HIV risk reduction.

Engaging in drug treatment during and after pregnancy improves both your health and the health of your unborn child. Give us a call today to learn more about your options 1-800-980-3927.
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References:

  1. Center for Behavioral Health Statistics and Quality. (2016). Results from the 2015 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
  2. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).
  3. Centers for Disease Control and Prevention. (2015). Unintended Pregnancy Prevention.
  4. Lewis, M., & Bendersky, M. (1995). Mothers, babies, and cocaine: The role of toxins in development. Psychology Press.
  5. Cressman, A. M., Natekar, A., Kim, E., Koren, G., & Bozzo, P. (2014). MOTHERISK ROUNDS: Cocaine Abuse During Pregnancy. Journal of Obstetrics and Gynaecology Canada, 36(7), 628-631.
  6. Fox, C. H. (1994). Cocaine use in pregnancy. The Journal of the American Board of Family Practice, 7(3), 225-228.
  7. National Institutes of Health. (2013). Tobacco, drug use in pregnancy can double risk of stillbirth.
  8. Rassool, G. H., & Villar-Luis, M. (2006). Reproductive risks of alcohol and illicit drugs: an overview. Journal of Addictions Nursing, 17(4), 211-213.
  9. World Health Organization. (2015). Preterm birth.
  10. Hughes, P., Turton, P., Hopper, E., & Evans, C. D. H. (2002). Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study. The Lancet, 360(9327), 114-118.
  11. Ness, R. B., Grisso, J. A., Hirschinger, N., Markovic, N., Shaw, L. M., Day, N. L., & Kline, J. (1999). Cocaine and tobacco use and the risk of spontaneous abortion. New England Journal of Medicine, 340(5), 333-339.
  12. WHITE, H. L., & BOUVIER, D. A. (2005). Caring for a patient having a miscarriage. Nursing2015, 35(7), 18-19.
  13. Viteri, O. A., Soto, E. E., Bahado-Singh, R. O., Christensen, C. W., Chauhan, S. P., & Sibai, B. M. (2015). Fetal Anomalies and Long-Term Effects Associated with Substance Abuse in Pregnancy: A Literature Review. American journal of perinatology, 32(05), 405-416.
  14. Taplin, S., Richmond, G., & McArthur, M. (2014). Identifying alcohol and other drug use during pregnancy: Outcomes for women, their partners and their children. ANCD Research Paper, 30.
  15. Berger, L. M., & Waldfogel, J. (2000). Prenatal Cocaine Exposure: Long‐Run Effects and Policy Implications. Social Service Review, 74(1), 28-54.
  16. Ashley, O. S., Marsden, M. E., & Brady, T. M. (2003). Effectiveness of substance abuse treatment programming for women: A review. The American journal of drug and alcohol abuse, 29(1), 19-53.
  17. Case Western Reserve University. (2017, May 3). Prenatal cocaine exposure increases risk of higher teen drug use. ScienceDaily.

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