Substance use during pregnancy can be dangerous in many ways.

Pregnant women who use substances regularly may have children who are born dependent on those substances. Babies who were regularly exposed to opioids in utero may develop neonatal abstinence syndrome (NAS), a collection of problems that happens because the baby is undergoing opioid withdrawal after birth. NAS may also refer to conditions caused by newborns withdrawing from other substances they became dependent on in utero.

Studies have found that smoking cigarettes, using opioids, drinking alcohol, using cocaine, and using methamphetamine while pregnant can each affect fetal development. Babies exposed to drugs in utero may experience developmental consequences including impaired growth, birth defects, and altered brain development. Prenatal drug exposure may impact the child’s behavior, language, cognition, and achievement long term. Drug use during pregnancy may also lead to miscarriage or pre-term labor.

Based on the 2017 National Survey on Drug Use and Health (NSDUH), an estimated 194,000 pregnant women between the ages of 15 to 44 (8.5%) have used illicit drugs in the past month, including an estimated 161,000 who used marijuana, an estimated 32,000 who misused pain relievers, an estimated 12,000 who misused tranquilizers, and an estimated 8,000 who misused cocaine. An estimated 334,000 pregnant women between the ages of 15 to 44 (14.7%) have used tobacco in the past month, and an estimated 261,000 used alcohol in the past month.

Physical Health Problems
  • Using opioids, cocaine, alcohol, nicotine, or other drugs during pregnancy may lead to:
    • Miscarriage
    • Pre-term birth
    • Low birth weight
    • Abnormal neurobehavior
    • Birth defects
  • Symptoms that the newborn is suffering from neonatal abstinence syndrome may include:
    • Crying that is excessive and/or high-pitched
    • Irritability
    • Trouble sleeping
    • Excessive sucking
    • Poor feeding, slow weight gain
    • Diarrhea, vomiting
    • Fever
    • Blotchy skin
    • Sweating
    • Quick breathing
    • Stuffy nose, sneezing
    • Hyperactive reflexes, increased muscle tone
    • Trembling, seizures

A baby whose mother used certain drugs while pregnant may suffer from long-term problems due to growth failure or birth defects involving the brain, heart, kidneys, or intestines. Infants exposed to drugs in utero have an increased risk of sudden infant death syndrome (SIDS).

Alcohol use during pregnancy is associated with impaired fetal growth, birth defects, and long-term impacts on growth. It may cause a fetal alcohol spectrum disorder (FASD) in the baby. The most severe type of FASD is fetal alcohol syndrome (FAS). FASDs may cause physical and psychiatric problems. Possible physical consequences of FASDs include:

  • Small head size
  • Abnormal facial features
  • Problems with vision or hearing
  • Low body weight
  • Shorter-than-average height
  • Poor coordination
  • Problems with sleep and sucking as a baby
  • Heart, kidney, or bone problems

Prenatal exposure to amphetamines may cause facial clefts, heart defects, and decreased fetal growth. Neonatal abstinence syndrome might occur in babies exposed to opioids prenatally. These infants may also have impaired growth in utero. Fetal growth reduction is also associated with the use of nicotine, cocaine, or methamphetamine.

Emotional and Behavioral Problems

Substances like nicotine, alcohol, opioids, and illegal drugs are associated with long-term mental and behavioral effects in children exposed to them prenatally, such as issues with:

  • Cognition
  • Language
  • Achievement
  • Behavior

In addition to the possible physical consequences of fetal alcohol spectrum disorders, potential psychiatric and social issues include:

  • Hyperactivity
  • Memory and attention problems
  • Intellectual disability or low IQ
  • Delays in speech and language
  • Learning disabilities and difficulty in school
  • Poor judgment and reasoning skills

Nicotine is linked to neurobehavioral impacts in infants and long-term effects on cognition, achievement, language, and behavior. Alcohol is associated with neurobehavioral effects in infants, and long-term impacts on cognition, language, achievement, and behavior. Marijuana exposure prenatally is related to some infant neurobehavioral alterations and long-term effects on cognition, behavior, and achievement.

Babies exposed to opioids prenatally may have neurobehavioral changes as an infant and long-term behavioral effects. Prenatal exposure to cocaine is associated with some impacts on infant neurobehavior and long-term effects on behavior, executive function, and language. Methamphetamine is linked to neurobehavioral alterations in infants.



Finding Help

Although anyone who struggles with a substance use disorder should seek treatment, it is especially important for women who are or may soon become pregnant. Some treatment centers have programs specifically for women. If you are currently pregnant, make sure any programs you enroll in are able to safely care for pregnant women.