The effects of drugs on the developing fetus are wide-ranging
and vary by substance and time of exposure, according to an
American Academy of Pediatrics (AAP) report. Early in gestation,
commonly used substances such as nicotine, alcohol, marijuana,
opiates, cocaine, and methamphetamines can have teratogenic
effects, but later in pregnancy, they're more closely associated
with brain development issues, wrote Marylou Behnke, MD, and
Vincent Smith, MD, of the AAP Committee on Substance Abuse and
Committee on Fetus and Newborn, in a technical report in
Pediatrics. Maternal alcohol use has been associated with fetal
growth challenges and intellectual disabilities, while opiate
use has been most significantly associated with neonatal
withdrawal issues, they found. "The primary care pediatrician's
role in addressing prenatal substance exposure includes
prevention, identification of exposure, recognition of medical
issues for the exposed newborn infant, protection of the infant,
and follow-up of the exposed infant,"