Your Pregnancy After 35 : Your Health and Medical History (part 10) - Substance Abuse

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33. Substance Abuse

Every action you take during pregnancy may potentially affect the baby growing inside you. Substance abuse is never healthy for you; when you’re pregnant, it can also harm your baby.

Many substances you normally use without adverse effects may adversely affect a developing fetus. Some substances readily cross the placenta and enter your baby’s bloodstream, where they can cause problems. Cigarette smoke, alcohol and drugs are dangerous for the fetus.

Cigarette Smoking

Cigarette smoking can have serious effects on you and your growing baby. Over 10% of all pregnant women smoke; some experts put the number at 20%. Smoking is higher among pregnant women under 20 years old and those over 35. Stop smoking before or during pregnancy; fetal and infant mortality rates increase by more than 50% in first-time pregnant women who smoke more than a pack of cigarettes a day.

Tobacco smoke contains harmful substances; when you smoke, so does your baby! When you inhale cigarette smoke, it crosses the placenta to your baby and may harm the fetus. In addition, nicotine in a pregnant woman’s bloodstream interferes with the normal development of the major neurotransmitter systems in a baby’s brain.

Nicoderm Patch/Gum, Zyban and Chantix

You may be wondering if you can use an aid, such as a patch, gum or a pill, to help you stop smoking during pregnancy. The specific effects on fetal development of these devices are unknown.

Nicotrol, available as an inhaler, nasal spray or patch, is sold under the brand names Nicoderm and Nicorette; it’s also sold generically. All three Nicotrol preparations contain nicotine and are not recommended for use during pregnancy.

Nicotine-replacement therapy may be suggested if a woman can’t stop smoking on her own. Studies show the benefits of these products may outweigh the risks during pregnancy, but some experts disagree. They state nicotine addiction cannot be stopped by using nicotine, which is contained in patches and gums. Discuss the situation with your healthcare provider if you have questions.

Zyban (bupropion hydrochloride) is an oral medication that is a nonnicotine aid to help with smoking cessation. This medication is also marketed as the antidepressant Wellbutrin or Wellbutrin SR. Zyban is not recommended for use by pregnant women.

Chantix (varenicline tartrate) is a prescription medication available to help someone stop smoking. It doesn’t contain nicotine, but it is not recommended for pregnant women. Studies show it may reduce a fetus’s bone mass and also cause low birthweight.

The problem is so serious that warnings for pregnant women appear on every cigarette package:

SURGEON GENERAL’S WARNING: Smoking by pregnant women may result in fetal injury, premature birth and low birthweight.

Some people mistakenly believe it’s OK to use smokeless tobacco during pregnancy. It’s not! Use of any smokeless tobacco product contributes to nicotine in the bloodstream.

In addition, if baby’s dad smoked before conception and during pregnancy, the child has an increased risk of developing problems during childhood. If both parents smoke while a child is growing up, the child may have an increased risk of developing lymphoblastic leukemia.

Effects on the Fetus

A pregnant woman who smokes reduces her fetus’s oxygen supply by as much as 50% because carbon monoxide in cigarette smoke displaces oxygen in the mother’s bloodstream. Toxins in cigarette smoke narrow blood vessels. Smoking can damage the placenta and hamper baby’s growth.

Smoking during pregnancy can increase the risk of many problems in a baby. Studies also show if you smoke during pregnancy, your child may have a much greater chance of being a smoker as an adult. The belief is that babies born to moms who smoke during pregnancy may be more susceptible to nicotine addiction.

Infants born to mothers who smoke weigh less than other babies, which can cause problems. When a woman smokes during pregnancy, the substances she inhales interfere with her body’s absorption of vitamins B and C and folic acid, and increase her risk of pregnancy-related complications.

Effects on the Pregnant Woman

Serious pregnancy complications are more common among women who smoke. The risk of developing placental abruption increases by 25% in moderate smokers and 65% in heavy smokers. Your smoking may affect future pregnancies. Studies show you double your risk of placental abruption in a second pregnancy if you smoke during your first pregnancy.

Placenta previa occurs 25% more often in moderate smokers and 90% more often in heavy smokers. Cigarette smoking also increases the risk of miscarriage, premature rupture of membranes and fetal death or death of a baby soon after birth. Risk is directly related to the number of cigarettes a woman smokes each day. Risk can be even greater if you smoke more than a pack of cigarettes a day.

The best thing to do is quit smoking completely before and during pregnancy. If you can’t quit totally, reduce the number of cigarettes you smoke to help reduce your risks.

Effects of Second-Hand and Third-Hand Smoke

Exposure to second-hand and third-hand smoke can be harmful for a mom-to-be and her baby. Second-hand smoke is smoke you breathe in when others around you are smoking. Third-hand smoke occurs when tobacco toxins stick to fabric, hair, skin and other surfaces, such as walls, carpets and floors, even after smoke has disappeared. It can be just as harmful as second-hand smoke. A clue to the presence of third-hand smoke is smell—if you can smell it, it’s still there.

Exposure to either type of smoke increases a nonsmoker’s risk of giving birth to a low-birthweight baby. Ask your partner, family members, friends and co-workers not to smoke around you while you’re pregnant. Avoid situations that expose you to second-hand or third-hand smoke!

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