Triggering factors for drug abuse in women 1. Factores desencadenantes del uso de drogas en mujeres. I Master in Nursing. E-mail: sonia. E-mail: mlfoliveira uem.
When the drug is taken during the 3rd trimester, discontinuation syndrome and persistent pulmonary hypertension Soxio the newborn. This is an important guide for all Sure Start or Nursery Workers, Health Visitors, Family Nurses, volunteers or anyone working with young children and families. Am J Psychiatry. Drug use itself is a barrier for a few women. American Journal of Drug and Alcohol Abuse. When lurasidone is taken during the 3rd duriny, increased risk of Socio groups drugs during pregnancy following:. I was just too doped up to hear anything. Nevertheless, the over-appreciation of the influence of friends, of "bad companies", may result from certain unaccountability or denial of intrafamily issues. Before taking any drug including over-the-counter drugs or dietary supplement including medicinal herbsa pregnant woman should consult her health care practitioner. Brief screening questionnaires to identify problem drinking during pregnancy: A systematic review Socio groups drugs during pregnancy report compares the usefulness of several questionnaires that are used to identify drinking problems among pregnant women.
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Clinicians should consider tapering the dose of all antidepressants during the Non caustic stripper trimester to reduce the risk of withdrawal symptoms in the neonate. Teratogenic in animals Socio groups drugs during pregnancy humans Potential for dose-dependent cardiac dysfunction. Persistent risk of congenital malformations despite folic acid supplementation. Live-virus vaccines such as the measles, mumps, and rubella vaccine ; polio vaccine ; chickenpox vaccine ; and yellow fever vaccine. Drug Name Select Trade Hydroxychloroquine. During pregnancy, drugs are often required to treat certain disorders. No antidote for reversal; to be avoided during pregnancy. Fetal growth restriction. Contraindicated during pregnancy and in women who may become pregnant. For example, nausea and vomiting may decrease absorption of an oral drug.
Women using drugs attend and avoid prenatal care for reasons not connected to their drug use: concern for the health of their baby, social support, and extrinsic barriers such as health insurance and transportation.
- Drugs are used in over half of all pregnancies, and prevalence of use is increasing.
- European Journal of Clinical Pharmacology.
Prevalence of drug abuse among pregnant women. The dependent variable was the use of drugs during pregnancy and independent variables were: socioeconomic and obstetrics-related data. Multivariate logistic regression indicates the following significant variables: years of education, participation in a pregnancy group and healthcare professional orientation as to the risk of using drugs during pregnancy.
Illegal drugs used were cocaine and its derivate, crack, as well as marihuana. Keywords: Primary care nursing; Maternal-child nursing; Clinical research nursing; Street drugs; Pregnant women; Substance-related disorders; Pregnancy complications.
The consumption of drugs has become a public healthcare problem, given that its inadequate use has been causing an increase of undesirable social events, such as family crises, violent episodes and preventable hospital stays, increasing the hospital bed occupancy rate, and, thus, leading to an overload in the Brazilian Unified Health System SUS, as per its acronym in Portuguese.
The expansion of psychoactive drug consumption, especially alcohol, cocaine - used in the powder form and in the impure forms of base paste, crack, merla and different crack derivations that can be smoked, has reached women in their fertile age, causing various medical and social challenges in the relation between drug use and mother-child health. The use of cocaine during pregnancy was once considered a crime in some US states.
Erroneous and biased interpretations of the literature can often affect educational programs and even lawsuits. There are deficiencies in the embracement of drug users, because when the social and cultural context in which the individual is inserted is recognized, it becomes possible to identify risk factors that permeate the dysfunctional use of drugs, a fundamental step for the creation of strategies for health teams with families and people in vulnerable situations.
Hence, comprehensive health care to pregnant women requires the study of drug abuse among these women so as to deal with them early and help them adequately in basic care. Thus, this study has the objective to determine the prevalence of drug abuse among pregnant women who use the prenatal service of health care centers.
Data were collected between January and July of The dependent variable was drug abuse during pregnancy. Independent variables were: age, years of education, marital status, profession, family income, race, pregnancy term, number of children, planned pregnancy, previous abortion, chronic diseases, hospitalization during pregnancy, participation in a pregnancy group and healthcare professional guidance as to the risks of drug use.
The only thing taken into consideration was the pregnant woman's declaration at the moment of interview. Data were arranged in spreadsheets using the software Excel for Windows Statistical analysis was performed using the calculation of frequencies of the defined variables.
The development of this study complied with national and international ethical guidelines for studies involving human beings. From the women interviewed, 72 The mean age of the pregnant women was From 72 women, As to obstetric variables, As to the multivariate logistic regression, significant variables were: years of education, participation in a pregnancy group and healthcare professional orientation as to the risk of using drugs during pregnancy.
Risk analysis showed an odds ratio of 9. Women who did not participate in a pregnancy group had 4. From the interviewed women, six 1. These figures are alarming, because from the women interviewed, 72 The effects of drug abuse during pregnancy have been reported on a number of studies, although as to illicit drugs, very few studies have been performed nationwide.
A study performed in Rio de Janeiro revealed that 5. The harmful effects of smoking are very subtle and harder to identify in relation to illicit drugs, and its use can go unnoticed to healthcare professionals, bringing consequences both during pregnancy and breastfeeding. In the past few decades, there was a decrease in the number of people who smoke, due to the increase in campaigns and local bans.
In relation to alcohol consumption, 6. The mechanisms through which alcohol affects the concept have not been fully explained so far. It is believed that the substance crosses the placental barrier, leaving the fetus exposed to concentrations similar to those in the maternal blood. Since metabolism and the elimination of alcohol are slower, the amniotic liquid is impregnated by the substance, making the environment inhospitable for the fetus and favoring the incidence of Fetal Alcoholic Syndrome FAS.
The variables years of education, participation in a pregnancy group and professional orientation at the health care center as to the risk of using drugs during pregnancy, have shown a statistically significant correlation, but that was not the case in the other studies. The prevalence of the use of illicit drugs was 1. The habit of using drugs, both illicit and licit, during pregnancy, may be underreported due to "guilty feelings" of the pregnant women, who, anticipating a possible repression and disapproval by the healthcare professional, may deny or underreport her drug use.
Drug use among pregnant women is a social and public healthcare problem. Pregnant women with chemical dependence have a lower participation rate in prenatal care, in pregnancy groups and a higher risk of obstetric and fetal problems.
They have a high-risk pregnancy, not only due to drug use during the development phase of the fetus, but also due to these women's social and emotional state. Therefore, it is important to offer specialized services to follow up this population and to detect drug use among pregnant women early. Kassada DS; Marcon SS; Pagliarini MA e Rossi RME have collaborated with the conception of this project, analysis and interpretation of data, writing of the article, relevant critical review of its intellectual contents and the final approval of the version to be published.
Gender differences in treatment-seeking brazilian drug-dependent individuals. Substance Abuse. Drogas de abuso e gravidez. Cocaine use during pregnancy assessed by hair analysis in a Canary Islands cohort. BMC Pregnancy Childbirth. Cienc Cuid Saude. Fetal alcohol spectrum disorder.
Journal of the School Nursing, Silver Spring. Rev Bras Ginecol Obstet. Assessment of prenatal exposure to tobacco smoke by cotinine in cord blood for the evaluation of smoking control policies in Spain. Women who smoke and stop during pregnancy: who are they? Mohsin M, Bauman A. Socio-demographic factors associated with smoking and smoking cessation among , pregnant women in New South Wales, Australia. BMC Public Health. Consequences of smoking during pregnancy on maternal health.
J Womens Health Larchmt. Predictors of postpartum relapse to smoking. Drug Alcohol Depend. Prenatal exposure to maternal and paternal smoking on attention deficit hyperactivity disorders symptoms and diagnosis in offspring. J Nerv Ment Dis. Teenage pregnancy: use of drugs in third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr. Submitted August 19, Accepted October 22, Conflicts of interest: no conflicts of interest to declare.
All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal. Discussion The effects of drug abuse during pregnancy have been reported on a number of studies, although as to illicit drugs, very few studies have been performed nationwide.
Collaborations Kassada DS; Marcon SS; Pagliarini MA e Rossi RME have collaborated with the conception of this project, analysis and interpretation of data, writing of the article, relevant critical review of its intellectual contents and the final approval of the version to be published. References 1. How to cite this article.
Crosses the placenta. Risk of a neonatal opioid withdrawal syndrome neonatal abstinence syndrome. We are very grateful to the staff at the Department of Health Insurance and Preventive Medicine and Hospital Discharge Registries in the County of Northern Jutland Sygesikringen, Amtsgaarden for excellent assistance in preparing the data for analyses. Persistent risk of congenital malformations despite folic acid supplementation. The highest overall prescription medication use was among women with basic schooling OR 1.
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Drug Use During Pregnancy - Women's Health Issues - MSD Manual Consumer Version
In general, drugs should not be used during pregnancy unless necessary because many can harm the fetus. Sometimes drugs are essential for the health of the pregnant woman and the fetus. In such cases, a woman should talk with her doctor or other health care practitioner about the risks and benefits of taking the drug. Before taking any drug including over-the-counter drugs or dietary supplement including medicinal herbs , a pregnant woman should consult her health care practitioner.
A health care practitioner may recommend that a woman take certain vitamins and minerals during pregnancy. Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the same route taken by oxygen and nutrients, which are needed for the fetus's growth and development.
Drugs that a pregnant woman takes during pregnancy can affect the fetus in several ways:. They can act directly on the fetus, causing damage, abnormal development leading to birth defects , or death. They can alter the function of the placenta, usually by causing blood vessels to narrow constrict and thus reducing the supply of oxygen and nutrients to the fetus from the mother. Sometimes the result is a baby that is underweight and underdeveloped.
They can cause the muscles of the uterus to contract forcefully, indirectly injuring the fetus by reducing its blood supply or triggering preterm labor and delivery. They can also affect the fetus indirectly.
For example, drugs that lower the mother's blood pressure may reduce blood flow to the placenta and thus reduce the supply of oxygen and nutrients to the fetus. Some of the fetus's blood vessels are contained in tiny hairlike projections villi of the placenta that extend into the wall of the uterus. The mother's blood passes through the space surrounding the villi intervillous space. Only a thin membrane placental membrane separates the mother's blood in the intervillous space from the fetus's blood in the villi.
Drugs in the mother's blood can cross this membrane into blood vessels in the villi and pass through the umbilical cord to the fetus. The genetic make-up of the mother, which affects how much of the drug is active and available.
Other factors related to the mother for example, if the mother is vomiting, she may not absorb as much of a drug, so the fetus is exposed to less of the drug.
A miscarriage. An increased risk of childhood cancer , as may result from giving the mother radioactive iodine to treat thyroid cancer or using a radioactive substance in an imaging test such as radionuclide scanning. The fetus's organs are developing, making the fetus particularly vulnerable to birth defects. Until recently, the Food and Drug Administration FDA classified drugs into five categories according to the degree of risk they pose for the fetus if they are used during pregnancy.
Drugs were classified from those with the least risk to those that are highly toxic and should never be used by pregnant women because they cause severe birth defects. One example of a highly toxic drug is thalidomide. This drug causes extreme underdevelopment of arms and legs and defects of the intestine, heart, and blood vessels in the babies of women who take the drug during pregnancy. The FDA's classification system was based largely on information from studies in animals, which often do not apply to people.
For example, some drugs such as meclizine cause birth defects in animals, but the same effects have not been seen in people. Taking meclizine for nausea and vomiting during pregnancy does not appear to increase the risk of having a baby with a birth defect. The classification system was based much less often on well-designed studies in pregnant women because few such studies have been done.
Thus, applying the classification system in specific situations was difficult. Because of this problem, the FDA eliminated the five risk categories.
Information to help health care practitioners decide whether the drug should be used during pregnancy and to help them explain the risks and benefits of using the drug to the woman. They consider giving a pregnant woman a drug to treat a disorder only when the potential benefit outweighs known risks. Often, a safer drug can be substituted for one that is likely to cause harm during pregnancy.
For prevention of blood clots, the anticoagulant heparin is preferred to warfarin. Several safe antibiotics, such as penicillin, are available to treat infections. Some drugs can have effects after they are stopped. For example, isotretinoin , a drug used to treat skin disorders, is stored in fat beneath the skin and is released slowly.
Isotretinoin can cause birth defects if women become pregnant within 2 weeks after the drug is stopped. Therefore, women are advised to wait at least 3 to 4 weeks after the drug is stopped before they become pregnant. Possible Problems. Antianxiety drugs.
Benzodiazepines such as diazepam , alprazolam , or lorazepam. When the drug is taken late in pregnancy, very slow breathing or a withdrawal syndrome causing irritability, shaking, and exaggerated reflexes in the newborn.
Aminoglycosides such as amikacin , gentamicin , neomycin , streptomycin , and tobramycin. In women or fetuses with G6PD deficiency , the breakdown of red blood cells. Fluoroquinolones such as ciprofloxacin , ofloxacin , levofloxacin , and norfloxacin.
Sulfonamides such as sulfasalazine and trimethoprim - sulfamethoxazole. When the drugs are given late in pregnancy, jaundice and, without treatment, brain damage kernicterus in the newborn. Slowed bone growth, permanent yellowing of the teeth, and increased risk of cavities in the child. Defects of the brain and spinal cord neural tube defects , such as spina bifida. Factor Xa inhibitors such as rivaroxaban , apixaban , or edoxaban.
Thrombocytopenia a decrease in the number of platelets, which help blood clot in the pregnant woman, possibly resulting in excessive bleeding. Birth defects , intellectual disability, cataracts, and other problems with the eyes in the fetus. When citalopram is taken during the 1st trimester, increased risk of birth defects particularly heart defects.
When citalopram is taken during the 3rd trimester, discontinuation syndrome which includes dizziness, anxiety, irritability, fatigue, nausea, chills, and muscle aches and persistent pulmonary hypertension of the newborn the arteries to the lungs remain narrowed after delivery, limiting blood flow to the lungs and thus the amount of oxygen in the bloodstream.
When escitalopram is taken during the 3rd trimester, discontinuation syndrome and persistent pulmonary hypertension of the newborn. When fluoxetine is taken during the 3rd trimester, discontinuation syndrome and persistent pulmonary hypertension of the newborn. When paroxetine is taken during the 1st trimester, increased risk of birth defects, particularly heart defects. When the drug is taken during the 3rd trimester, discontinuation syndrome and persistent pulmonary hypertension of the newborn.
When sertraline is taken during the 3rd trimester, discontinuation syndrome and persistent pulmonary hypertension of the newborn. When venlafaxine is taken during the 3rd trimester, discontinuation syndrome. Antiemetic drugs used to relieve nausea. When ondansetron is taken during the 1st trimester, possible risk of congenital heart disease. Antifungal drugs. Antihypertensive drugs. With spironolactone , possible development of feminine characteristics in male fetuses.
With eplerenone , no increased risk of birth defects in animals, but no well-designed studies done in pregnant women. Angiotensin-converting enzyme ACE inhibitors. When the drugs are taken late in pregnancy, kidney damage in the fetus, a reduction in the amount of fluid around the developing fetus amniotic fluid , and defects of the face, limbs, and lungs.
When some beta-blockers are taken during pregnancy, a slowed heart rate, a low blood sugar level, and possibly inadequate growth of the fetus growth restriction and preterm birth. Calcium channel blockers. Thiazide diuretics. A decrease in the levels of oxygen, sodium, and potassium and in the number of platelets in the fetus's blood. Antipsychotic drugs. When haloperidol is taken during the 1st trimester, possibly birth defects in the limbs. When haloperidol is taken during the 3rd trimester, increased risk of the following:.
Restlessness, irritability, shaking, difficulty breathing, and feeding problems symptoms of drug withdrawal in the newborn because at birth, passage of the drug from the mother through the placenta stops. When lurasidone is taken during the 3rd trimester, increased risk of the following:. When olanzapine is taken during the 3rd trimester, increased risk of the following:.
No evidence of increased risk of birth defects, but no well-designed studies done in pregnant women. When risperidone is taken during the 3rd trimester, increased risk of the following:. Antiseizure drugs. Bleeding problems in the newborn hemorrhagic disease of the newborn , which can be prevented if pregnant women take vitamin K by mouth every day for a month before delivery or if the newborn is given an injection of vitamin K soon after birth.
High risk of birth defects such as cleft palate and defects of the heart, skull, face, hands, and abdomen. Some risk of birth defects, including cleft palate, neural tube defects such as a meningomyelocele , and defects of the heart, face, skull, spine, and limbs. Chemotherapy drugs. Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot.
Inadequate growth of the fetus growth restriction. Mood-stabilizing drug. When lithium is taken during the 1st trimester, increased risk of birth defects mainly of the heart. When lithium is taken later in pregnancy, lethargy, reduced muscle tone, poor feeding, underactivity of the thyroid gland, and nephrogenic diabetes insipidus in the newborn.
When the drugs are taken late in pregnancy, a reduction in the amount of fluid around the developing fetus. When low doses of aspirin are taken, no significant risk of birth defects. No evidence of increased risk of birth defects but may have other harmful effects on the fetus or newborn. Restlessness, irritability, shaking, difficulty breathing, and feeding problems symptoms of drug withdrawal in the newborn.
If high doses are given in the hour before delivery, possibly drowsiness and a slowed heart rate in the newborn. Oral antihyperglycemic hypoglycemic drugs.