Substance Use During Pregnancy

Area of Science:

• Obstetrics
• Psychiatry
• Public Health

Background:

• Pregnancy involves significant maternal physical, mental, and psychological transitions.
• Substance use during pregnancy is a major preventable cause of newborn developmental delays and birth defects.
• Maternal mental health symptoms like anxiety and depression can intensify, potentially becoming psychiatric syndromes, especially with vulnerability factors.

Purpose of the Study:

• To review the challenges obstetricians face in detecting and managing substance-related disorders during pregnancy.
• To highlight the limitations in current obstetric practice for addressing substance use.
• To discuss the difficulties in collaborative care between obstetricians and psychiatrists for pregnant individuals with addiction.

Main Methods:

• This is a narrative review reflecting the obstetrician's perspective.
• Analysis of the constraints within the obstetric therapeutic framework regarding time, training, and tools.
• Examination of the suitability of validated detection questionnaires in obstetric practice.

Main Results:

• Validated detection questionnaires are often ill-suited for routine obstetric practice.
• Delegating detection and brief interventions may save time but can reduce obstetrician engagement.
• Integrated management of pregnancy and addiction is hindered by differing disciplinary frameworks and timelines.

Conclusions:

• Substance use during pregnancy requires careful management, as no amount or timing is safe.
• Obstetricians require better tools and training to effectively detect and manage substance use disorders.
• Improved collaboration and adapted frameworks are needed for effective combined care between obstetricians and psychiatrists.