Pediatrics Jobs and Drug Use Amongst Pregnant Women

One of the most challenging situations that can arise in pediatric populations is when mothers who abuse drugs become pregnant and then deliver babies with problems stemming from the mother's drug habits. Pediatricians are faced with treating these situations more frequently than most readers may imagine. Current studies have suggested that up to 15% of women drink alcohol and anywhere between 5% and 15% use illicit drugs during pregnancy. The most commonly used substances are tobacco, alcohol, marijuana, cocaine, and methamphetamine. Sadly, because some mothers may use many drugs at the same time, or may not give an accurate and complete history when reporting their drug habits, it's often difficult to ascertain which substances are causing symptoms in a newborn. Nonetheless, pediatrics jobs involve dealing with the realities of drug abuse and providing realistic solutions.

The two most commonly used 'hard' drugs during pregnancy are cocaine and methamphetamine. These particular substances most frequently cause maternal effects like hypertension (high blood pressure), a lower amount of blood flow to the uterus, fetal hypoxemia (lack of oxygen in the blood), uterine contractions, and placental abruption (when the placenta separates from the lining of the uterus). Compared with healthy mothers, drug users have a two to four-fold increase in the rates of devastating consequences - stillbirth (where the baby dies before it is delivered), IUGR (intrauterine growth restriction - where the fetus fails to grow properly), preterm labor, and placental abruption. None of these outcomes is desired by any pediatrician, much less parents, yet, they are the reality of drug use during pregnancy, and pediatricians must evaluate and treat these situations.

Another class of medicines that may be abused during pregnancy and which negatively affect infants delivered to addicted mothers is the opioid family of drugs (narcotics). Opioids, when they are used in pregnancy, can lead to infants that display neurological symptoms such as irritability, hyperactivity, unceasing and extremely high-pitched crying, and seizures. Gastrointestinal symptoms can include vomiting, diarrhea, weight loss, poor feeding habits or lack of desire to eat. Respiratory symptoms can include nasal congestion, sneezing, yawning, sweating, and hyperthermia. These symptoms are similar whether the mother has used narcotic pain medicines, heroin, or methadone, and they usually become noticeable in infants within the first 1-3 days of life. Infants showing symptoms of opioid withdrawal can first be treated by swaddling them and placing them in a dimly lit environment to minimize disturbances. If this does not lessen their symptoms, or if they have excessive diarrhea or vomiting, then appropriate does of phenobarbital can be administered to ease their suffering. These infants have a four to five-fold increase in the risk of SIDS (sudden infant death syndrome), and even after their infancy are likely to suffer neurobehavioral problems.

Anyone who is tasked with caring for mothers and their infants would advise pregnant mothers against exposing themselves and their unborn children to the toxic effects of drugs, whether legal or illegal. Alcohol is included in this list - it's the only legal drug that is clearly toxic to the fetus - prenatal exposure to alcohol is the most common preventable cause of mental retardation. Pediatricians, nurses, and others who work with newly pregnant women are making increased efforts to assess and treat the causes of drug abuse in women. Women with drug addiction are especially urged to seek treatment upon discovery that they are pregnant to prevent further harm to their unborn babies.