Pregnancy Information Fetal Development Substance Abuse

Alcohol consumption, drug abuse, smoking and even excessive coffee drinking can affect a pregnancy. During pregnancy, alcohol, drugs, and other toxic substances can pass through the placenta to the fetus, causing birth defects such as fetal alcohol syndrome.

Fetal Alcohol Syndrome

In the United States, approximately one in every 750 pregnancies results in fetal alcohol syndrome (FAS). Fetal alcohol syndrome occurs when a woman drinks heavily during pregnancy. FAS is the leading cause of birth defects and mental retardation in the US. The effects of alcohol during pregnancy are even more severe than those caused by the abuse of illegal drugs such as cocaine, heroin and marijuana.

Symptoms of Fetal Alcohol Syndrome

Fetal alcohol syndrome causes damage during pregnancy that lasts a lifetime. Children with fetal alcohol syndrome display a variety of physical and mental defects and developmental delays, including:

  • attention disorders
  • behavioral problems
  • epilepsy
  • flat cheekbones
  • heart problems
  • inadequate social skills
  • lack of imagination
  • learning disorders
  • low birth weight
  • motor skill delays
  • poorly developed groove between upper lip and nose
  • small eye openings
  • small head
  • stunted growth.

The symptoms of fetal alcohol syndrome follow a child throughout life, disrupting school performance and social life. As adults, people with fetal alcohol syndrome often have problems with employment and relationships. Mental health problems, law enforcement conflicts, and inappropriate sexual behavior are all more common in people with fetal alcohol syndrome.

How Much Alcohol Is Safe?

Exactly how much alcohol causes fetal alcohol syndrome is unknown. While fetal alcohol syndrome usually results from alcohol abuse and heavy drinking, any amount of alcohol during pregnancy is considered dangerous to the fetus.

In addition to fetal alcohol syndrome, other alcohol-related disorders can occur during a pregnancy. Fetal alcohol effects (FAE) describe a condition in which some, but not all, symptoms of fetal alcohol syndrome are present. Up to 50,000 cases of fetal alcohol effects are reported yearly in the US. Other results of drinking during pregnancy can include ARBD (alcohol-related birth defects), and ARND (alcohol-related neurodevelopmental disabilities). Children born with ARND lack the physical symptoms of fetal alcohol syndrome, but mirror the mental and behavioral problems of FAS.

Preventing Fetal Alcohol Syndrome

Fetal alcohol syndrome is completely preventable. No alcohol should be consumed at all during pregnancy. The risk of fetal damage during pregnancy is simply too great. If you know you’re pregnant, don’t drink alcoholic beverages.

This advice also applies to women trying to get pregnant. A pregnancy may be undetected for several weeks. Alcohol consumption in the initial weeks of pregnancy can damage the fetus. Abstaining from alcohol while planning a pregnancy is an important safety precaution.

For women who suffer from alcohol abuse, substance abuse counseling may help control alcohol consumption during pregnancy. If you have a problem with alcohol abuse, doctors and counselors can help you make your pregnancy as safe as possible for your child.

Smoking, Caffeine, and Pregnancy

In addition to alcohol, other legal “drugs” can be harmful during pregnancy. The toxins in cigarettes can cross the placenta, increasing the risk of miscarriage, low birth weight and premature delivery. Smoking during pregnancy has also been linked to sudden infant death syndrome (SIDS). There is no safe limit for smoking during pregnancy: Cigarettes should be avoided. Women who smoke may require counseling or a doctor’s assistance to quit smoking for the duration pregnancy and, preferably, after the birth.

Consumption of caffeine should also be restricted during pregnancy: Caffeine has caused birth defects in laboratory animals. Most experts believe that up to one cup of coffee a day will do no harm during a pregnancy, but many women choose to forgo caffeinated beverages until the end of their pregnancy.

Illicit Drug Abuse and Pregnancy

Drug abuse during pregnancy places the fetus at terrible risk. While fetal alcohol syndrome is more common than drug abuse- related birth defects, drug abuse nevertheless causes serious and lifelong disabilities. Some mothers may require drug abuse counseling and support to overcome addiction and ensure a safe pregnancy.

Cocaine and Pregnancy

Cocaine drug abuse during pregnancy retards fetal growth, and interferes with nervous system development. Cocaine abuse also increases the risk of premature birth.

Cocaine abuse may cause “placental abruption.” When this occurs, the placenta separates from the uterus and causes bleeding, which may be fatal to the mother and child. A child whose mother uses cocaine during pregnancy is twenty times more likely to die in the first year of life than a child whose mother doesn’t.

Opiate Drug Abuse

Opiate drug abuse during pregnancy must be handled carefully. Methadone and heroin may be dangerous during pregnancy if dosage levels fall as well as when they rise. A pregnant woman suffering from opiate drug abuse should enter a methadone clinic so drug levels can be strictly monitored through the pregnancy.


Beers, M. H.