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Your Pregnancy After 35 : Your Health and Medical History (part 11) - Alcohol, Abuse of Other Substances

- 7 Kinds Of Fruit That Pregnant Women Shouldn’t Eat
- How to have natural miscarriage
- Foods That Cause Miscarriage
- Signs Proving You Have Boy Pregnancy

33. Alcohol

When you drink, so does your baby—the more you drink, the more your baby “drinks.” Alcohol use by a pregnant woman carries considerable risk to her and her developing baby. The fetus is especially vulnerable to the effects of alcohol in early pregnancy.

Drinking during pregnancy has been associated with behavior problems in a child. The more alcohol a woman drinks, the more problems a child may experience. Drinking as little as two drinks a day has been associated with fetal-alcohol effects. Chronic use of alcohol during pregnancy can lead to fetal-alcohol syndrome (FAS); see the discussion below.

Your developing baby may be harmed by an alcohol level that has little apparent effect on you. A fetus cannot metabolize alcohol as quickly as an adult, so alcohol remains in its system much longer. Moderate use of alcohol has been linked to a greater risk of miscarriage. Studies show spina bifida is up to 60 times more common in babies exposed to alcohol before birth than in babies who were not exposed.

Before pregnancy, Wendy drank socially, but she hadn’t missed alcohol during her pregnancy. She felt that by abstaining from alcohol, she was doing something good for her baby. At a party, she was offered a glass of wine. The pregnancy was going well, and she hadn’t had any problems; what would be the harm? She wasn’t sure, so she decided to stay with fruit juice. At her next prenatal visit, she wanted to know how much alcohol she could drink safely. I supported Wendy in her decision not to drink at all during her pregnancy. I told her that research has not identified a “safe” amount of alcohol to consume during pregnancy. The more we learn, the more it appears that even a little alcohol might be harmful.

The word is spreading about alcohol use in pregnancy, but one study found many pregnant women in North America ignore the advice. In that study, four times as many women said they drank alcohol during pregnancy than those who had been interviewed in an earlier study. Don’t put your baby at risk! Pass up all alcohol during your pregnancy.

You may wonder about recipes that call for alcohol. It’s OK to eat food that contains alcohol if it has been baked or simmered for at least 1 hour. Cooking for that length of time cooks out almost all of the alcohol content.

Some women wonder if nonalcoholic wine and beer are safe to drink during pregnancy. Even though they are labeled “no alcohol,” these beverages contain some alcohol—about 0.5%. Because we don’t know what alcohol-intake level is safe for the fetus, it’s a good idea to avoid these beverages.

If you drink during pregnancy, it may affect sperm production in a male child born from that pregnancy. Researchers have noted an association between alcoholic intake of the mother and sperm concentration in her adult son.

Taking drugs with alcohol increases the risk of damage to the fetus. Drugs that cause the greatest concern include analgesics, antidepressants and anticonvulsants.

Some researchers believe heavy alcohol consumption by a baby’s father before or at the time of conception may produce FAS in the baby. Alcohol consumption by the father has also been linked to intrauterine-growth restriction.

Be very careful about substances you use that may contain alcohol. Over-the-counter cough medicines and cold remedies often contain alcohol—as much as 25% of the preparation!

Fetal-Alcohol Syndrome and Fetal-Alcohol Exposure

Fetal-alcohol syndrome (FAS) is a collection of problems that affect children born to alcoholic women. Mild abnormalities have been associated with as little as two drinks a day (1 ounce of alcohol)—this is called fetal-alcohol exposure (FAE).

FAS occurs in 1 or 2 of every 1000 births. It is characterized by growth restriction before and after birth. Heart and limb defects and unusual facial characteristics, such as a short, upturned nose, a flat upper jawbone and “different” eyes, have also been seen in FAS children. These children may have behavioral problems, impaired speech and impaired gross-motor functions. FAS ranks with neural-tube defects and Down syndrome as a major cause of mental retardation in babies.

We advise women that any amount of alcohol is too much. It’s best to avoid alcohol completely while you’re pregnant!

33. Abuse of Other Substances

When we discuss substance abuse, we refer to use of drugs prohibited by law, but we also include use of legal medications, such as benzodiazepine or barbiturates. These substances may also have harmful effects during pregnancy, regardless of whether they are used for legitimate or illicit reasons.

Drug use can greatly affect your pregnancy. A woman who uses or abuses drugs may have more pregnancy complications because of her lifestyle. Women who use certain substances commonly display nutritional deficiencies; anemia and fetal-growth restriction are other risks. A pregnant woman who uses drugs may increase her risk of pre-eclampsia.

Marijuana

Marijuana contains tetrahydrocannabinol (THC), which crosses the placenta and enters the baby’s system. Exposure can cause attention-deficit disorders, memory problems and impaired decision-making ability in children; these problems can appear in a child between 3 and 12 years of age.

Central-Nervous-System Drugs

When used during pregnancy, central-nervous-system stimulants, such as amphetamines, are associated with an increase in cardiovascular defects in babies. These babies frequently show signs of withdrawal, poor feeding, seizures and other problems.

Tranquilizing agents include benzodiazepines (Valium and Librium) and other agents; they have been associated with an increase in birth defects. Heavy use in pregnancy is also associated with infant withdrawal after birth.

Narcotics and Mind-Altering Drugs

Habitual use of morphine, Demerol, heroin and codeine can lead to physical dependence in the user. A pregnant woman who uses narcotics is subject to pre-eclampsia, preterm labor, fetal-growth problems and narcotic withdrawal in the baby following birth. The incidence of sudden-infant-death syndrome (SIDS) is 10 times higher among babies born to mothers who used narcotics during pregnancy than babies whose mothers did not.

Intravenous drug use is frequently accompanied by health problems, such as AIDS, hepatitis and endocarditis. Any of these problems is extremely serious during pregnancy.

Hallucinogens, such as LSD, mescaline, hashish and peyote, are still used by many people. Phencyclidine (PCP, angel dust) falls into this group. PCP is believed to cause abnormal development in human babies, although this has not been definitively proved.

Cocaine and Crack

Cocaine use can definitely complicate a pregnancy. Often a user consumes the drug over a period of time, such as several days. During this time, the user may eat or drink very little, with serious consequences for a developing fetus.

Continued use of cocaine or its stronger form, crack, can affect maternal nutrition and temperature control, which can harm the fetus. Cocaine use has been linked with many pregnancy problems. A woman who uses cocaine during the first 13 weeks of pregnancy faces an increased risk of miscarriage. Cocaine can damage the developing baby as early as 3 days after conception!

Infants born to mothers who use cocaine during pregnancy often have mental deficiencies. Sudden-infant-death syndrome (SIDS) is also more common among these babies. Many babies are stillborn.

One of the most difficult discussions I’ve had was with Sally. When she came to see me for her yearly exam and Pap smear, she was upset and discouraged. Adam, her 10-year-old pride and joy, was now in fifth grade. He was having trouble in school and had been diagnosed with attention-deficit disorder. Her pregnancy had seemed to go OK 10 years ago. She hadn’t been able to talk about it then, but she said she had continued using cocaine through the first part of her pregnancy. She was now contemplating another pregnancy. Sally realized that although there was nothing she could do now to change her pregnancy with Adam, she would do things differently with this baby.

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