Effects of Drug Use on Fetal Development

About this course

Pregnancy is extremely sensitive to external elements that can cross the placental barrier, damage the uterus or placenta, or affect the mother’s health. These external elements can interfere with fetal development, affecting the maturation and calibration of organs and systems, which can lead to abnormal growth and increase the risk of short and long-term health problems. This course overviews the stages of fetal development, how the stages are affected by drug use, short-term health concerns, and long-term development delays in babies exposed to drugs in-utero.

Learning objectives

• Describe the stages of fetal development.
• Recognize pregnancy related complications associated with maternal drug use.
• Review the effects of teratogens on fetal development.
• Understand the signs of neonatal abstinence syndrome and options for treatment.
• Explain the long-term effects of in-utero drug exposure.

Course outline

21 sections · finish in any order across devices

1. 1

   Introduction

   Fetal development is an intricate and highly orderly process that occurs during gestation; the time between conception and birth.1 Typically lasting 37 – 40 weeks, gestation sees a fertilized egg grow into a fully formed human with complete organs and mature systems able to function without life sup

   4 min

2. 2

   Stages of Fetal Development

   During pregnancy, there are three stages of fetal development, germinal, embryonic, and fetal.1

   4 min

3. 3

   The First Trimester

   The first trimester is the period from conception to the end of Week 12.1 As it includes the germinal and embryonic stages, it lays the foundation for the development of all critical body systems and bones. Compared to other trimesters, this stage sees the most rapid growth, including the formation

   4 min

4. 4

   The Second Trimester

   The second trimester sees the maturation of all the systems formed in the first trimester.1 It is counted from the start of Week 13 to the end of Week 27.10 During this period, the fetus’s skin is red and wrinkly, covered by soft downy hair known as lanugo. To protect this underdeveloped skin, a whi

   4 min

5. 5

   The Third Trimester

   The final phase of pregnancy is known as the third trimester.1 It starts from the beginning of Week 28 until birth by Week 37 – 40 (full-term). Throughout this stage, the fetus will grow in size and weight to be healthy enough to survive unsupported outside the uterus.1,10

   4 min

6. 6

   Drug Use Increases Risk of Pregnancy Complications

   During every pregnancy, hormonal levels fluctuate considerably to prepare and regulate the mother’s body so it can support the development of a fetus.2 These hormonal adjustments result in numerous physiological changes at a cellular level that affect all systems, from the circulatory to the digesti

   4 min

7. 7

   Hypertension

   Also known as high blood pressure, drugs with vasoconstrictive effects increase arterial pressure, reducing the amount of blood moving through the blood vessels to vital organs such as the placenta and uterus.4,5 Not only does high blood pressure increase the risks of damage to organs, it also incre

   4 min

8. 8

   Infection

   Illicit drug use via unsterilized syringes during pregnancy may introduce harmful viruses and bacteria to the body, which can cross the placental barrier to reach the fetus. Moreover, drug use can weaken a pregnant woman’s immune system, making her and the fetus more susceptible to infection. This e

   4 min

9. 9

   Preterm Labor, Miscarriage, and Stillbirth

   Given the numerous side effects of drugs, their usage during pregnancy can induce preterm labor (birth before Week 37).1,11 A fetus born during this time is still immature, with underdeveloped systems, and will require immediate medical attention to increase its chances of survival. However, if pret

   4 min

10. 10

    Fetal Growth Restriction

    All teratogens have been found to cause fetal growth restriction (FGR), which is defined as severe weight loss in a fetus such that it weighs less than the 10th percentile for its gestational age.14 The severity of FGR is assigned based on the estimated fetal weight. Moderate FGR is a fetal weight b

    4 min

11. 11

    Alcohol

    Alcohol consumption during pregnancy is a leading cause of preventable birth defects in the United States.2 It is a known cause of fetal growth restriction, where the average birth weight of babies exposed to large amounts of alcohol in-utero is 4 lbs. compared to the normal average of 7 lbs.15

    4 min

12. 12

    Cocaine

    Cocaine is known to narrow blood vessels, and when used during pregnancy, can substantially reduce the blood supply to the fetus.17 Babies exposed to cocaine in-utero have been seen to have low birth weights, smaller head circumferences, and shorter lengths than those not exposed to cocaine.15

    4 min

13. 13

    Marijuana

    The exact effects of marijuana during pregnancy are unknown, but its main component, tetrahydrocannabinol (THC), is known to cross the placenta. Some research suggests that heavy use can cause health issues in newborns, including lower birth weight and abnormal neurological development.5,15,18

    4 min

14. 14

    Heroin and Prescription Opioids

    Heroin is a synthesized substance derived from morphine, a naturally occurring chemical in opium poppy plants.20 This highly addictive substance binds to opioid receptors on cells, dulling pain and producing a sensation of euphoria. Prescription opioids such as OxyContin®, Percocet®, Demerol®, and V

    4 min

15. 15

    Ketamine

    Ketamine has many medical uses, including being an adjunct to general anesthesia, treating chronic pain, and management of treatment-resistant depression.23,24 It is also used recreationally for its psychedelic effects.23

    4 min

16. 16

    Ativan

    Ativan®, the proprietary name for lorazepam, is a prescription medication for anxiety disorders, sleep problems, severe agitation, and active seizures.26 It is classified by the federal drug administration (FDA) as a Category D drug, meaning it can potentially harm a developing fetus. Studies have s

    4 min

17. 17

    Ibuprofen, Aspirin, and other NSAIDs

    Ibuprofen and aspirin are drugs classified as non-steroidal anti-inflammatory drugs (NSAIDs) that relieve pain, reduce inflammation, and reduce a fever.28 Despite their effectiveness, these drugs are generally not given during pregnancy because studies have suggested they increase the risk of compli

    4 min

18. 18

    Neonatal Abstinence Syndrome (NAS)

    Fetal withdrawal is a serious consequence of in-utero exposure to specific addictive drugs such as heroin, prescription opioids, certain antidepressants, sleeping pills, ethanol, and even caffeine and inhalants.33 Drugs such as cocaine and marijuana do not lead to fetal withdrawal.15,20,33

    4 min

19. 19

    Developmental Delays and In-Utero Drug Use

    The long-term effects of in-utero drug exposure depend on several factors, including the type of drug, the amount used, the frequency of use, and its timing in terms of trimester. Moreover, how a substance reacts with a fetus varies from case to case, making it increasingly challenging to predict po

    4 min

20. 20

    Nursing Considerations

    One of the most challenging aspects of preventing drug use during pregnancy is stopping usage in time. Most women are unaware of their pregnancy, and it isn’t until they are 2 – 3 weeks late for their expected period that they find out.1,2,10 By this time, their pregnancy may be in or have completed

    4 min

21. 21

    Conclusion

    Fetal development is a complex process dependent on a safe environment to ensure healthy growth.1 Drug use during pregnancy can severely impair this development, drastically increasing the risk of life-threatening complications for both the mother and the fetus. These complications can result in pre

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

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• Capitanio, J. P., Del Rosso, L. A., Calonder, L. A., Blozis, S. A., & Penedo, M. C. T. (2012). Behavioral effects of prenatal ketamine exposure in rhesus macaques are dependent on MAOA genotype. Experimental and Clinical Psychopharmacology, 20(3), 173–180. https://doi.org/10.1037/a0026773
• Bais, B., Molenaar, N. M., Bijma, H. H., Hoogendijk, W. J., Mulder, C. L., Luik, A. I., Lambregtse-van den Berg, M. P., & Kamperman, A. M. (2020). Prevalence of benzodiazepines and benzodiazepine-related drugs exposure before, during and after pregnancy: A systematic review and meta-analysis. Journal of Affective Disorders, 269, 18-27. https://doi.org/10.1016/j.jad.2020.03.014
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• Wong, S. H., & Chan, F. K. (2016). Adverse effects of NSAIDs in the gastrointestinal tract: Risk factors of gastrointestinal toxicity with NSAIDs. NSAIDs and Aspirin, 45-59. https://doi.org/10.1007/978-3-319-33889-7_4
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