Literature review: Risky Substance Exposure during Pregnancy

Women often take substances that are harmful to them and their child during pregnancy. Sometimes they do it knowingly; like users of alcohol and smokers while other times they don’t. Assessment of young adolescent drug users who had been pregnant was done at random. The study was aimed at trying to describe the qualities of young pregnant drug users and to explore their complicating factors and psych-social risks. It also sought to determine if they were in conflict with authorities. The study found that all the girls selected had undergone abusive and unstable experiences through childhood. They were also found in relationships with other drug users who were themselves drug abusers. It was also found that all had been required to have mental health examinations and over 90% of them had an account of self injury. All the girls had also been involved in criminal activities that ranged from assault, break-ins, theft and possession of illegal weapons (Barnes, Ismail & Crome, 2010).

According to the report, these girls had a low level of education and education would not help in combating their situation. The researchers recommend that social issues like domestic abuse, homelessness and social isolation would help to reduce the rates of drug abuse among pregnant adolescent. This conclusion was based on the fact that most of these girls were involved in similar social situations (Barnes, Ismail & Crome, 2010). According to this paper, it also seems that unemployment is a big issue. The girls go to the extent of obtaining money for drugs through prostitution. They lack a good education and so work is a problem too.

According to Parrish, Sternberg, Velasquez, Cochran, Sampson, & Mullen, (2012), fetal alcohol syndrome which is caused by alcoholism during pregnancy is to blame for several incurable serious complications. They argue that the US government spends over $4 billion on medical care for such complications. Owing to these complications, the children are also requiring special education for which the government pays a further $2 million per child (Tenkku, Morris, Salas & Xaverius, 2009). This is very high costs for the governments to cover. However, the bigger problem is that of raising a child with special needs.

Regardless of these statistics, the study shows that while most women would reduce their drinking during their pregnancies, the white women were the most likely to reduce. The minority groups also had their reduction differing across the groups. Due to the variance, the best method to approach the situation would have been to target specific groups and educate them on the hazards of drug use during pregnancy (Tenkku, Morris, Salas & Xaverius, 2009). Targeting in this case should be done on racial grounds. It has been noted that complications are more among these groups which do not reduce their alcohol intake during pregnancy.

Another study showed that there was a big overlap on nicotine and alcohol abuse. It noted that about seventeen percent of pregnant women were at risk of nicotine exposed pregnancies. The largest percentage of those at risk was in prison and drug rehabilitation centers. To this problem, the authors suggest that preconception models be targeted at both nicotine abusers and alcohol abusers. The women involved needed to be sensitized to start alcohol and nicotine cessation in their preconception period when it was easier to control substance abuse. They recommended a model known as the CHOICES model which they had used in their studies (Parrish et al., 2012).

Smoking is associated with two to four times increase in attention-deficit hyperactivity disorder (ADHD) (Lindblad & Hjern, 2010). They also note that while this research was carried primarily on people with a Swedish background, it proved sufficiently that the influence of tobacco was a chief factor. It shows a need for mothers to stop smoking as it has a relationship with ADHD. The research also shows an interconnection between smoking and drinking. The interconnection shows that women who smoke are also likely to be drinkers. It would therefore be wiser and more economical to approach the two situations together. The approach would then best be done by physicians as they often command the trust of their patients.

According to research, until 1973, while the effects of prenatal drinking had been associated with several problems, it had not until recently been diagnosable by doctors. Identifying patients with alcohol-induced conditions still remains a problem. Research is being concentrated on people suffering from people suffering fetal alcohol spectrum disorders so that their problems can be reduced or eliminated. This way, it is expected that most the burden on the victims will be further reduced both for them and their families (Warren, Hewitt & Thomas, 2010).

These authors feel that the best way to deal with the problem is to research fro medicinal solutions to resolve the issues. They however encourage counseling of pregnant women, before, during and after pregnancy. This way, they argue, parents will understand the risk under which they expose their children. Extreme cases, however, should be taken to rehabilitation centers (Warren, Hewitt & Thomas, 2010). Education should always seek to inform and to sensitize.

Buprenorphine is a medication taken for those are dependent on opioid.  A study looking at its effects on infant development showed that it worked just as well as another medication known as methadone. Other studies have shown changes in the neurodevelopment of the fetus and neonatal abstinence. The research however shows that this drug is getting up as a favorite for various physicians (Konijnenberg & Melinder, 2011). The drug in this case is the only option that doctors have. The drug has a slight risk of hurting the baby but failure to use it would be destructive to the child.

Usage of high amounts of alcohol has been associated with various birth defects. A higher maternal age was associated with an increased risk of drinking during pregnancy. It was noted that there were higher risk factors that were associated with pregnancy for younger women such as first birth, unmarried, working, and more experienced related to alcohol abuse. It was however, also, discovered that older women were much more likely to get drunk while pregnant. The study also highlights the importance of information. It campaigns for education of pregnant mothers since according to them they do not know what risks to avoid. According to their report, education is vital to the fight against substance abuse amongst pregnant women (Meschke, Holl & Messelt, 2013).

According to a study on Hispanic women living in South Carolina wanted to understand the consumption habits of women in terms of food, drinks and medications. It found that while most of them took proper measures in ensuring a good diet, some others made uninformed choices in terms of foods, drinks and medications. Amongst the foods most favored by pregnant women were fresh fruits, meat, milk and dairy products and juice. It was however noted that other took wrong products such as BPA, methylmercury, alcohol, caffeine and certain medications. These were all termed as unhealthy as they were likely to cause complications for the unborn child. This represents a lack of information that should actually be made available for pregnant women. From this information, they argued that while information about what they should confirm is necessary, focus should be put on unhealthy foods so that parents do not complicate the health of their children (Santiago, Park & Huffman, 2013).

Another research which was carried out showed that women who got drunk increased chances of losing their child. It was noted that still births, miscarriages, preterm deliveries, sudden death syndromes were more common among women who drank. Alcohol consumption has been shown to lead to placental dysfunction, impaired blood flow, placental size, endocrine changes and impaired nutrient transport. These factors contributed to make the above occurrences. To reduce such occurrences, the report suggests that physicians should make sure that they advice patients who are taking alcohol and if possible help them medicinally to stop drinking (Bailey & Sokol, 2011).

The use of medicinal substances that are risky to children can be disastrous. It comprises major health disquiet. According to a study that sought to understand the use of harmful substances among women found a number of occurrences. In this report, drugs, alcohol, tobacco and caffeine were used. Information was thoroughly checked to ensure that mothers did not lie. The files of the mother and the baby as well as the baby itself were checked to make sure proper details were given and also to check on the health of the babies born. The consumption of these substances was found to affect health of the child born. The study showed that Lebanese women were exposed to drugs at all levels of their pregnancies. The study suggests that governments should adopt measures to reduce the exposure of pregnant women to harmful substances (Rachidi et al 2013).

In conclusion, we note that various substances are likely to cause complications to the mother and the unborn child. For this reason, various initiatives should be adopted to ensure that governments reduce the access to drugs. Failure top access such drugs will be very beneficial for women. Another method would be to have counselors who are easily accessible to pregnant women. Counselors should be able to inform mothers on both the meals that are suitable for them and what is not. If parents are informed about good practices early, they will tend to avoid them. The government should also invest in civil education. This will enable more people to learn about the problems that may arise from drug abuse during pregnancy.

Governments should also implement ways to deal with social issues such as homelessness, child abuse and poverty. This way, they will be able to reduce cases of drug abuse by pregnant adolescent girls. These girls have had histories of such social problems and often escape into drug abuse for a sense of belonging or to relieve their stress. This explains why they have all had mental tests.

References

BAILEY, B. A., & SOKOL, R. J. (2011). Prenatal Alcohol Exposure and Miscarriage, Stillbirth, Preterm Delivery, and Sudden Infant Death Syndrome. Alcohol Research & Health, 34(1), 86-91.

Barnes, W., Ismail, K. K., & Crome, I. B. (2010). Triply troubled: Criminal behaviour and mental health in a cohort of teenage pregnant substance misusers in treatment. Criminal Behaviour & Mental Health, 20(5), 335-348. doi:10.1002/cbm.776

Konijnenberg, C., & Melinder, A. (2011). Prenatal exposure to methadone and buprenorphine: A review of the potential effects on cognitive development. Child Neuropsychology, 17(5), 495-519. doi:10.1080/09297049.2011.553591

Lindblad, F., & Hjern, A. (2010). ADHD after fetal exposure to maternal smoking. Nicotine & Tobacco Research, 12(4), 408-415. doi:10.1093/ntr/ntq017

Meschke, L., Holl, J., & Messelt, S. (2013). Older Not Wiser: Risk of Prenatal Alcohol Use by Maternal Age. Maternal & Child Health Journal, 17(1), 147-155. doi:10.1007/s10995-012-0953-7

Parrish, D., Sternberg, K., Velasquez, M., Cochran, J., Sampson, M., & Mullen, P. (2012). Characteristics and Factors Associated with the Risk of a Nicotine Exposed Pregnancy: Expanding the CHOICES Preconception Counseling Model to Tobacco. Maternal & Child Health Journal, 16(6), 1224-1231. doi:10.1007/s10995-011-0848-z

Rachidi, S., Awada, S., Al-Hajje, A., Bawab, W., Zein, S., Saleh, N., & Salameh, P. (2013). Risky substance exposure during pregnancy: a pilot study from Lebanese mothers. Drug, Healthcare And Patient Safety, (default), 123.

Santiago, S. E., Park, G. H., & Huffman, K. J. (2013). Consumption habits of pregnant women and implications for developmental biology: a survey of predominantly Hispanic women in California. Nutrition Journal, 12(1), 1-14. doi:10.1186/1475-2891-12-91

Tenkku, L., Morris, D., Salas, J., & Xaverius, P. (2009). Racial Disparities in Pregnancy-Related Drinking Reduction. Maternal & Child Health Journal, 13(5), 604-613. doi:10.1007/s10995-008-0409-2

WARREN, K. R., HEWITT, B. G., & THOMAS, J. D. (2011). Fetal Alcohol Spectrum Disorders: Research Challenges and Opportunities. Alcohol Research & Health, 34(1), 4-14.