Question about pre-natal drug exposure

Factual Questions
1

Okay…

Lets just say that I have this friend, right? And lets say this friend’s mother was prettily heavily involved in the drug trade for much of her early life. Lets say this friend’s mother was taking illegal narcotics (such as, for instance, cocaine) during the time she concieved my friend, but quit when she realized she was pregnant, which was several months into said pregnancy. Lets say that my friend is now nearly an adult. What problems might this prenatal drug exposure have caused? Are their any medical issues I should be aware of? Can exposure to narcotics while a fetus have any noticable effect on my mental health or make me more susceptible to addiction?

.:Nichol:.

2

If the prenatal exposure was going to cause a physical problem it would have shown up by now.

There is some evidence - but in no way conclusive - that children of addicts are slightly more likely to become addicts themselves. Whether this is due to genetics, prenatal exposure, or growing up in an environment where drugs/alcohol are being used regularly and therefore seem “normal” is anyone’s guess.

Mental health problems might also be more likely - but again, whether that’s genetics, prenatal exposure, or growing up in a high-stress environment is completely unknown.

If this person has reached adulthood physically normal with no learning disabilities, no unusual mental problems, and hasn’t started using “substances” then they’re probably going to be completely OK. And that is a very common outcome for children of addicts. If they are having any of the above problems that’s an indication there may be trouble… but that doesn’t mean they’re doomed to travel the same road as their parent(s). Certainly, some do, but then children of teetotaling mentally normal people become addicts, too.

In other words, we don’t really know why one person has a drug problem and another doesn’t.

3

This article discusses research on monkeys and seems to suggest that cocaine use by the mother during pregnancy has negative effects on brain development.

This article from parentsplace includes the following:

*Congenital anomalies occur in 7 to 26 percent of infants exposed to cocaine in utero. Cocaine can adversely affect embryonic and fetal development through interruption of uterine, placental, and fetal blood flow. Evidence of brain malformation or hemorrhage occurs in approximately 35 percent of infants exposed to cocaine in utero. Fetal cardiovascular abnormalities caused by maternal use of cocaine have been reported to occur in 4 to 40 percent of babies exposed to cocaine in utero. Defects or disruption of urinary and genital development have been found in 14 percent of infants exposed to cocaine n utero.

Following the birth, withdrawal symptoms are experienced in 31 percent of newborns exposed to cocaine in utero. These include seizures, depression, lethargy, feeding problems, hyperactive reflexes, vomiting, diarrhea, high- pitched cry, and restlessness. These symptoms may indicate damage to the central nervous system that may prevail throughout life.

On long-term follow-up, cocaine-exposed infants demonstrate significant cognitive and developmental delay.*

It looks like there is the possibility for all sorts of problems later in life. If they haven’t appeared in an obvious way, than your “friend” may have been lucky. However, there is concern that more subtle effects may occur, as this site suggests:

Many may recall that “crack babies,” or babies born to mothers who used cocaine while pregnant, were written off by many a decade ago as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration. Most crack-exposed babies appear to recover quite well. However, the fact that most of these children appear normal should not be over-interpreted as a positive sign. Using sophisticated technologies, scientists are now finding that exposure to cocaine during fetal development may lead to subtle, but significant, deficits later, especially with behaviors that are crucial to success in the classroom, such as blocking out distractions and concentrating for long periods of time.

As far as whether these children are more susceptible to addiction as adults: While my quick search didn’t turn up anything (and, as Broomstick notes, there are so many other factors that will have an effect) I think it makes sense that when babies are born addicted and have to go through withdrawal after birth, they must have a lifelong addiction already in place.

4

GAHHHH!

Sorry, pet peeve of mine - a baby born “addicted” is not addicted in the sense the term is used by medical folks. “Addiction” is a mental condition, meaning it involves brain chemistry AND behavior. A “baby addict” actually has a physical dependence and goes through physical withdrawal but is completely without the use drugs/get high/get low/seek drugs/use drugs/etc. cycle that is the hallmark of true addiction.

Also - when the “baby addict” is withdrawn from drugs and “clean” they are still NOT an addict and do NOT maintain addictive behaviors (since they haven’t had time to acquire any). The only question is whether the pre-natal exposure alters brain chemistry permanently (post-natal addiction certainly can, but does not always) in such a manner as to make the use of drugs more appealing and therefore makes the individual more likely to become addicted later in life.

In other words, if a baby is born with heroin in his/her system and is detoxed at birth it would not be proper to refer to him/her as a “recovering addict” or “former addict”. Because they have never been an addict. “Pre-natally exposed” may not have the same ring, but it’s the more accurate term.

Here’s another parallel - promiscuity may lead to sexually transmitted diseases in a pregnant woman that may be passed on to the child, but even if the child has the clap at birth that does NOT make the little tyke sexually promiscuous. Nor does it mean the kid has a “life long promiscuity already in place” at birth. Pre-natal exposure to STD’s may cause profound damage, and may leave the victim more vulnerable to all sorts of medical problems, but in no way does it mean that the child, when grown, will automatically be promiscuous him/herself or automatically acquire an STD problem.

5

Broomstick, you are absolutely right. My language was sloppy and I thank you for correcting me. I am a childbirth educator and, as such, have occasion to discuss these issues with my students. It is important for me to express myself clearly and precisely. I won’t make this mistake again.

As you say, addiction involves both brain chemistry and behavior. My thinking is that the brain chemistry issue is key here, if we are looking at the future prospects of a child born to a drug-addicted mother. That child, when he grows up, can make deliberate choices about his behavior, but he can do nothing about his brain chemistry.

There is a well-known Swedish study that looked at the relationship between the use of opiates during labor and eventual drug addiction once the babies reached adulthood. There was a very clear link found, with an increased risk associated with greater drug exposure. It would seem reasonable to me to assume that babies born to cocaine addicted mothers might have the same sort of addictive tendancies already hard-wired in their brains.

There seems to be no simple answer as to why some people can use mood-altering chemicals freely and never abuse them, while others become easily and powerfully addicted. Individual brain chemistry would seem to be a likely factor. I would advise any adult who knows of significant drug exposure during his time in utero to be very cautious with regards to his own behavior.

6

I’d like to thank everyone for taking the time to reply. I really do appreciate it.

If this person has reached adulthood physically normal with no learning disabilities, no unusual mental problems, and hasn’t started using “substances” then they’re probably going to be completely OK.

Well, my “friend” has no noticeable physical ailements, but does have several learning/neurological disorders, including dyslexia and trichtotillomania (compulsive hair pulling). My "friend"s brother, also born while their mother was an addict, is a paranoid schizophrenic and a drug abuser himself. My “friend” has never abused drugs, however.

Robinh, special thanks from me for finding that website. In one place it says:

scientific studies have documented that babies born to mothers who abuse cocaine during pregnancy are often prematurely delivered, have low birth weights and smaller head circumferences, and are often shorter in length

Both my “friend” and her brother were very small, frail babies (in sharp contrast to their first cousins, born of non-addicted mothers, who were all fat, healthy, sturdy things) and both stayed in the hospital for several weeks immediantly after their births due to sicknesses and general ill health. I don’t know what their head circumferences were, and I also don’t know what a typical newborn head’s circumferences would be in order to compare them.

Many may recall that “crack babies,”

I don’t think “crack babies” quite suit my “friend” and her brother. Their mother was addicted to hydrochloride salt cocaine, not crack.

.:Nichol:.

7

Here’s an interesting wrinkle I heard in a college class a few years back.

Mom is doing a little coke (or whatever) during the time the female fetus’ reproductive organs are developing. Remember, a woman is born with every egg she will ever have, only guys continue to produce sperm throughout their lives.

So, said daughter is born with no problems. Whew, dodged a bullet there, right? Maybe not. It is possible that HER eggs have been damaged, and that Grandma’s drug use may result in grandchildren with birth defects, or no grandchildren at all.

A study? Don’t have one, unfortunately, but I’ll see what I can find. Sounded like a reasonable possibility when I heard it, but maybe someone in the field can debunk it.

8

Nichol, the data that you’ve posted suggest that your “friend” has done a good job of growing up in an environment that was less than optimal. The couple of things which you mentioned are no big deal, lots of people cope with these things everyday and many other people have worse problems with which they struggle.

Please tell your “friend” that the SDMB can be a nice place, there are some people here that can talk to her when she needs someone to talk to, share experiences with, etc. I hope to see her around here and that she continues to do well.

9

The damage done by cocaine to a fetus is primarially due to restricting the flow of oxygen. This is far more likely to screw up something in the brain or nervous system than to affect the developing reproductive organs.

I chalk this sort of thing up to the old UL that LSD and pot cause chromosome damage. Anti-drug scare tactics.

10

I attempted to parent a cocaine exposed child for two years.
His mother used sizable amounts every day of her pregnancy. Dad was “importing” it himself, so they had the good stuff.
This kid had noticable problems from the time he was two. By 14 he was in a locked down “learning facility”. He lit fires, stole, lied and had no conscience that I ever saw.
I’d say, if your “friend” is over 12 and has no major problems, you probably don’t need to worry.