It never ceases to amaze me that in spite of all the warnings, large numbers of women continue to use tobacco, alcohol, and other drugs when they’re pregnant. Yes, I understand that addiction is a difficult thing to beat, but if you can’t do it for yourself, what better reason is there than to do it for your child? It’s like my dad always said, “There’s this little thing called responsibility….” I was so worried about hurting my kids that during my pregnancies, I stopped using all sources of caffeine and caffeine-like substances, including coffee, tea, colas, and even chocolate. For my students who rarely see me without a coffee cup in hand, this is quite shocking.

None of us think that drugs are good for fetuses, but now we have new evidence that prenatal use of tobacco, alcohol, cocaine, and marijuana decrease gray matter volume and head circumference in school age children (10-13 year olds) [1].

Image provided by Science Daily and Children's Hosptial, Boston

If you compare the thickness and fullness of the gray matter indicated by the little arrows, you will see the differences between the control child on the right (no prenatal exposure to drugs) and the child on the left, who was exposed prenatally to tobacco, alcohol, cocaine, and marijuana.

The researchers found significant effects for each of the drugs alone, but the strongest effects were in cases where multiple drugs were used. Because this is the typical pattern (few cocaine users abuse only cocaine), these findings are definitely troublesome. Obviously, the anatomical effects of prenatal exposure to drugs is not something kids just outgrow. Hopefully, we can get this message across to moms.

1.  Rivkin, M.J., Davis, P.E., Lemaster, J.L., Cabral, H.J., Warfield, S.K., Mulkern, R.V., Robson, C.D., Rose-Jacobs, R., & Frank, D.A. (2008). Volumetric MRI study of brain in children with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana. Pediatrics, 121(4), 741-750.


7 Comments

Rick · April 8, 2008 at 11:54 am

I’m curious, though, if the researchers were able to correlate differences in brain volume to observable behavioral deficits. This reminds me of an article I read a few months (years?) ago following up on the “crack babies” that were the focus of such national attention about 20 years ago. Turns out that there were no major differences in functioning (I don’t remember how it was measured…I’ll see if I can find the reference) between so-called crack babies and non-crack babies. The brain is an amazing thing….

Laura Freberg · April 8, 2008 at 1:56 pm

Unfortunately, Pediatrics is on interlibrary loan for me, so I won’t be able to see the complete paper for a few days. I don’t see anything in the abstract that would suggest that they used behavioral measures to compared the groups of children. That would seem to be a logical next step.

Is this the paper you were thinking of? Griffith DR, Azuma SD, & Chasnoff IJ. (1994). Three-year outcome of children exposed prenatally to drugs. Journal of the American Academy of Child and Adolescent Psychiatry. 33(1), 20-7. This paper found that exposure to cocaine predicted poor verbal reasoning and exposure to marijuana predicted poor abstract/visual reasoning. However, the authors conclude “Contrary to information in the popular media, not all substance-exposed children suffer the same poor prognosis. In fact, generalizations about the fate of drug-exposed children must await additional research into the outcome of the broader population of drug-exposed children, examining the roles of maternal and environmental factors across a variety of geographic locations and socioeconomic levels.”

IMHO, this kind of research is terribly difficult to do well, as few moms are likely to be forthcoming about the extent of their drug use, and most are doing multiple drugs. In addition, if a mom is inattentive enough to health to be doing drugs during pregnancy, how likely is she to follow good prenatal care, good diet, vitamins, etc?

jmgraham · April 8, 2008 at 9:19 pm

I am taking Cognitive Development along with Bio Psych this quarter and we just talked about the affects of these teratogens on brain development last night. It is so sad that mothers continue to do this. However, researchers have found that the reason why it is still so prevalent is because women don’t know they are pregnant. In fact, most women don’t find out until 4-8 weeks. By then, these drugs have already begun to affect the development of the fetus. So even with increased awareness on the affects of there drugs, behavior won’t change (if it does at all) until the mother actually knows that she is carrying a child.

AprilN · April 8, 2008 at 10:55 pm

With all the information available and out there, it’s sad that many babies are born with problems such as this. The affects of teratogens play such a strong role in pregnancy, that it’s important for expectant mothers to realize this. The sad part is that there are many parents, who are abusing substances, possibly don’t care enough to kick their habits. Many women don’t know their pregnant until after several weeks, and by then, damage has already taken place.

l.ogden · April 15, 2008 at 2:33 pm

I’ve known about the effects of drugs and other teratogens on fetuses for a while. I agree that it is a shame some mothers don’t care enough to change their harmful habits for the child. But, I was wondering how much the less harmful things, like caffeine, affect the fetus. I learned that caffeine in moderation is perfectly alright for the child, but was wondering what inspired you to cut it out of your diet completely? What does it do, even in small amounts?

mbernie · April 17, 2008 at 11:44 am

Drug use puts so much pressure/stress/chemicals on/into the user that I can’t even imagine the amounts going into the child in proportion to their body size. A mother should know better than to put her baby in risk and even if she is in a “drug fog” someone, such as a relative, friend or heaven forbid the father should do or say something if not report to the authorities. A child’s life is in the hands of a drug addict and there is no excuse to let this happen if one can prevent it. Many of the drugs listed in the article are sine qua non, in the users mind, to their survival but someone should remind them that it can lead to huge setbacks if not death to themselves and their child. If a mother does care enough to stop her illegal bad habits she should just get an abortion because if she is this bad at pregnancy imagine how bad she’ll be at being a mom.

Also, can this drug use lead to a baby becoming a savant?

A_Jolly · May 4, 2008 at 7:21 pm

I have heard in other classes that there are no significant mental disabilities in children born addicted. Low birthweight-yes, less grey matter-no. I guess this is fairly new then. My question is how will study effect adoption rates? I interned at C.P.S and it always amazed me that mothers could poison their unborn children. I had to remove newborns from thier mothers many times. I was surprised how honest the mother’s were about thier drug use while pregnant.

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