Solvent abuse in pregnancy: a perinatal perspective

To review the scope and sequelae of solvent abuse in women presenting to a Manitoba teaching hospital.

Fifty-six patient charts with a diagnosis of solvent abuse in pregnancy were identified through computer search in the medical records of Winnipeg Health Sciences Centre, General Hospital. These charts were reviewed and data obtained from birthing records and associated pediatric charts.

Renal tubular acidosis was diagnosed in three patients (5.3%). Two patients (3.6%) had adverse neurological sequelae. One patient was diagnosed with brain damage, including expressive aphasia. Twelve patients (21.4%) delivered preterm infants. Nine infants (16.1%) had major anomalies. Seven infants (12.5%) had fetal alcohol syndrome (FAS)-like facial features. Six neonates (10.7%) had hearing loss.

Substance abuse in pregnancy is associated with severe maternal and neonatal sequelae. Physicians must be aware of this increasing problem in the obstetrical population and assistance should be offered to each woman, ideally before a woman becomes pregnant, but at least at the first contact a pregnant woman makes with the health care community.