Drug Testing for Newborn Exposure to Illicit Substances in Pregnancy: Pitfalls and Pearls
Table 1
Possible effects on newborns due to illicit drug use in pregnancy (not a complete list).
Drug
Possible effects on the newborn
Stimulants:
Perinatal:
Methamphetamine, Cocaine.
Low birth weight [10–12] CNS irritability/lability of state [13–15] —crying, jittery, sleep/wake alterations may have continued exposure through breastfeeding Neurodevelopmental alterations [16] Necrotizing enterocolitis [17] (Teratogenicity suggested by case studies but not confirmed by larger cohort or animal studies) [18]
Long term: Modest but measurable longitudinal differences of cocaine-exposed infants in growth [19, 20], cognition [21], language [22], and impaired behavioral self-regulation [23, 24]. Other risk and protective factors can moderate outcome [23–25]. Longitudinal cohort of amphetamine-exposed infants showed school and behavioral problems (but environment impacts as well) [26]. Longitudinal methamphetamine studies are underway [27].