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Infants of mothers with substance use disorder

Lauren M Jansson, MD
Section Editor
Joseph A Garcia-Prats, MD
Deputy Editor
Melanie S Kim, MD


Substance use disorder during pregnancy is a serious problem for both the mother and her newborn infant. For the mother, episodes of drug withdrawal during pregnancy and illnesses related to high-risk behavior may occur. Consequences for the offspring exposed to prenatal substance use disorder include neonatal abstinence syndrome (NAS) or other neurobehavioral effects that present shortly after birth, potential congenital malformations, low birth weight (BW) for gestational age (GA) (intrauterine growth restriction [IUGR]), prematurity, and long-term adverse effects on growth and development [1]. In addition, these infants are placed at increased risk due to the mother's poor prenatal care and are at higher risk of being exposed to prenatally acquired infection [1].

The clinical features and management of neonates born to mothers with substance use disorders will be reviewed here. Substance use disorder during pregnancy is discussed separately. (See "Cigarette smoking: Impact on pregnancy and the neonate" and "Alcohol intake and pregnancy" and "Substance misuse in pregnant women".)


Abuse of licit substances, including alcohol and opioid-containing pain relievers, and illicit drug use during pregnancy are not uncommon.

Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings reported illicit drug use was 5 percent, alcohol use was 9.4 percent with 2.6 percent binge drinking and 0.4 percent heavy drinking [2].

A retrospective analysis of a nationally representative sample of newborns with neonatal abstinence syndrome (NAS) reveals that between 2000 and 2009, the rate of newborns with NAS increased from 1.2 to 3.39 per 100 hospital births per year. Between 2000 and 2009, the number of mothers using or dependent on opiates increased from 1.19 to 5.63 per 1000 hospital births per year [3].

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Literature review current through: Nov 2017. | This topic last updated: Aug 08, 2017.
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