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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Illicit drug use and neonatal outcomes: a critical review

Ashley H Schempf1

  • 1Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. aschempf@jhsph.edu

Obstetrical & Gynecological Survey
|October 11, 2007
PubMed

Insights

Prenatal illicit drug use, particularly cocaine, is linked to adverse neonatal outcomes like reduced fetal growth. Addressing surrounding factors is crucial for improving infant health.

Area of Science:

  • Neonatal Health
  • Perinatal Epidemiology
  • Substance Abuse Research

Background:

  • Neonatal effects of tobacco and alcohol are known, but evidence on prenatal illicit drug use is inconsistent.
  • Social, psychosocial, behavioral, and biomedical factors complicate the assessment of illicit drug use on birth outcomes.
  • Prevalent views often overestimate the direct impact of illicit drugs compared to confounding factors.

Purpose of the Study:

  • To review recent epidemiologic literature on the neonatal impact of marijuana, opiate, and cocaine use.
  • To highlight inconsistencies and challenges in evaluating the effects of prenatal illicit drug exposure.
  • To provide recommendations for future research directions.

Main Methods:

  • Systematic review of recent epidemiologic studies.
  • Focus on marijuana, opiate, and cocaine use during pregnancy.
  • Analysis of neonatal outcomes and confounding variables.

Main Results:

  • Cocaine use shows the most consistent association with fetal growth decrements, with observed dose-response effects.
  • Studies often lack adequate control for social, psychosocial, and contextual factors.
  • Evidence for marijuana and opiate use on neonatal outcomes is less consistent.

Conclusions:

  • Interventions must address multifaceted factors surrounding drug use, including social circumstances, nutrition, stress, and infections, to improve neonatal outcomes.
  • Further research is needed to disentangle the direct effects of illicit drugs from confounding variables.
  • Improving neonatal health requires a comprehensive approach beyond solely focusing on drug exposure.

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