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Substance Use and Toxicity Deaths in Pregnancy
Andi Camden1, Astrid Guttmann1, Jonathan Zipursky2
1Edwin S.H. Leong Centre for Healthy Children, The Hospital for Sick Children and the University of Toronto, Toronto, ON; ICES, Toronto, ON.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|January 22, 2026
Summary
Substance use in pregnancy is rising, with drug toxicity contributing to nearly 1 in 4 pregnancy-related deaths. Comprehensive, individualized care is essential for pregnant individuals with substance use disorders and their infants.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Addiction Medicine
Background:
- Substance use during pregnancy presents significant risks to both the pregnant individual and the fetus.
- Drug toxicity is a growing concern, contributing to maternal and infant morbidity and mortality.
- Understanding the epidemiology and risk factors is crucial for effective intervention.
Purpose of the Study:
- To review the current literature on the epidemiology of substance use in pregnancy.
- To identify characteristics and risk factors associated with drug toxicity in pregnancy.
- To synthesize information on the treatment of substance use disorders in pregnant individuals.
Main Methods:
- A narrative literature review was conducted.
- Searches included PubMed, Google Scholar, and Google up to February 2024.
- Focus was on recent, English-language, and Canadian studies.
Main Results:
- Substance use in pregnancy has significantly increased in Canada over the last two decades.
- Nearly 25% of pregnancy-associated deaths involve substance use, highlighting the severity of drug toxicity.
- Opioid use is most common, but combined use with stimulants and benzodiazepines is rising.
Conclusions:
- There is a critical need for comprehensive, individualized, and trauma-informed care approaches.
- Addressing the complex health and social needs of pregnant individuals with substance use is paramount.
- Improved care strategies are necessary for both the individuals and their children.
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