Recreational drugs

Use of recreational drugs and other substances in women of childbearing potential is common and enquiries regarding the fetal risks following inadvertent exposure during early pregnancy are therefore also frequent. Misuse of drugs throughout or in later pregnancy may also impact on fetal well-being, and in some cases confer a risk of potentially serious effects in the neonate, such as neonatal withdrawal. Data demonstrating the extensive and lifelong problems associated with in utero exposure to alcohol are now vast and have been fundamental in informing the development of programs to reduce maternal alcohol use in pregnancy, and to improve diagnosis of fetal alcohol spectrum disorders in exposed individuals to enable early assessment and intervention. Unfortunately, the full fetal effects of drugs such as cannabis, opiates, amphetamines, cocaine and hallucinogens remain to be determined and use in pregnancy is therefore not advisable. This chapter summarizes the published literature regarding the fetal risks associated with maternal use of recreational drugs, cigarettes, caffeine and alcohol during pregnancy, the latter in the context of both regular and binge-drinking. Where applicable, recommendations regarding additional fetal monitoring or interventions are provided.