DEFINITION
More than 50% of pregnant women using drugs, both drugs are
prescribed by doctors, the drugs are sold freely, or even drugs and illicit
substances (such as cocaine, alcohol, or tobacco).
Generally, the drugs should not be used during pregnancy,
unless it is very necessary. This relates to the risks that can harm the fetus,
for example, the occurrence of congenital defects. Nevertheless, there are
certain medications that are important to the health of pregnant women and the
fetus, such as certain vitamins and minerals. Therefore, before using
medication or supplements, pregnant women should consult a physician first.
CAUSE
The drugs consumed by pregnant women can get to the fetus,
particularly through the placenta, along with the entry of nutrients and oxygen
required for growth and development of the fetus.
The drugs are consumed by a pregnant woman can affect the
fetus in several ways:
Working directly on the fetus, is to cause damage,
developmental abnormalities (causing birth defects), or even death.
Interfere with placental function, thus making the supply of
oxygen and nutrients to the fetus is reduced. Sometimes these conditions make
babies have low birth weight and less developed.
Creating strong muscles of the uterus to contract, which can
reduce the blood supply to the fetus or trigger birth prematurely.
Affect the fetus indirectly, for example by reducing the
mother's blood pressure, so it can make a reduction in blood flow to the
placenta resulting in the supply of oxygen and nutrients to the fetus is
reduced.
SYMPTOMS
How drugs affect the fetus depends on the level of
development of the fetus, as well as the strength and dose of drugs used.
Level of Fetal Development
Effects of the drug within 20 days after conception lethal
or no effect at all. At this time the fetus is highly resistant to the
occurrence of birth defects.
At the age of 3-8 weeks after fertilization, the use of
drugs can cause miscarriage, congenital defects, or may not effect anything. At
this time, the organs of the fetus is growing, so that the fetus is susceptible
to the occurrence of birth defects.
When the second and third trimesters, fetal organ
development is complete. The use of drugs is unlikely to pose a clear Bawan
defects at birth, but it is not known about the long-term effects. However,
there could be a change in the normal growth and function of organs and
tissues.
Strength and Drug Dosage
FDA (The Food and Drug Administration) classifies medicines
based on risk to the fetus if used during pregnancy. Some drugs are highly
toxic to the fetus, so it should not be used for pregnant women. For example,
thalidomide. Several decades ago, thalidomide causes severe developmental
disorders in the hands and feet, as well as abnormalities in the intestine, heart,
and blood vessels from babies conceived by women who become pregnant while
taking this drug.
Some drugs can cause effects although it has been
discontinued, such as isotretinoin, a drug used to treat skin irritation.
Isotretinoin is stored in the fat under the skin and is released slowly.
Therefore, although the use of these drugs has been discontinued, but the
effect will still exist for a certain time. Isotretinoin can cause birth
defects if pregnancy occurs within 2 weeks after the drug is discontinued.
Women who use isotretinoin are advised to wait for at least 3-4 weeks after the
drug is stopped, before she was pregnant.
Effects Use of Recreational Drugs or Prohibited Substance
Pregnancy
Smoking (tobacco). Smoke effects that are harmful to
pregnant women and the fetus. Effects of smoking on the fetus most commonly
found is the lack of birth weight. The more a woman smokes during pregnancy,
the less weight gain babies.
In addition, pregnant women who smoke also can cause:
·
Congenital defects of the heart, brain, and the
baby's face. This condition is more common in babies born to women smokers,
rather than women who do not smoke.
·
Increased risk of sudden death syndrome
·
Improper position of the placenta (placenta
previa)
·
Placenta separated early
·
Premature birth
·
Infection of the uterus
·
Miscarriage
·
Stillbirth
Children born to women who smoke also have a slight
disturbance in physical growth and intellectual development and behavior. This
is caused by carbon monoxide and nicotine in cigarettes. Carbon monoxide can
reduce the oxygen supply to the tissues of the body. Nicotine stimulates the
release of hormones that constrict blood vessels, which supply blood to the
uterus and placenta, as a result of oxygen and nutrients to the fetus less.
Pregnant women who do not smoke should avoid cigarette smoke
(no secondhand smoke), because it would also harm the fetus.
Alcohol. Alcohol consumption during pregnancy is known to
cause the most likely to cause birth defects. The risk of miscarriage is also
increased by nearly 2X in women who drink alcohol during pregnancy, especially
if he is a heavy drinker.
Another effect of the use of alcohol on the fetus, among
others:
·
Often the baby's birth weight is lower than
normal
·
Newborns of women who drink alcohol during
pregnancy may have failed to grow and tend to die shortly after birth
·
Alcohol syndrome in infants, which consists of:
·
inadequate growth before or after birth
·
facial deformities
·
small head size (possibly due to inadequate
brain growth)
·
intellectual impairment
·
the development of abnormal behavior.
·
abnormalities positions and joint function
·
heart defects
·
Severe behavioral disorders in infants or
children, for example, anti-social behavior and attention deficit disorder.
·
Caffeine is found in coffee, tea, some sodas,
chocolate, and certain medications. Caffeine can get into the fetus through the
placenta and cause:
·
increased heart rate
·
decrease blood flow to the placenta
·
decrease the absorption of iron, so that it can
increase the risk of anemia
Some evidence suggests that drinking more than seven cups of
coffee a day can increase the risk of stillbirth, premature birth, miscarriage,
or the birth of a baby with low birth weight.
Amphetamines. Amphetamine use during pregnancy can cause
birth defects, especially of the heart, and the possibility of inadequate
growth before birth.
Marijuana. The main component of marijuana,
tetrahydrocannabinol ie, can cross the placenta and can harm the fetus.
However, marijuana does not seem to increase the risk of birth defects or
obstacles in the growth of the fetus.
Cocaine can cross the placenta and cause constriction of
blood vessels and increases the blood pressure of the fetus. Cocaine use by
pregnant women can cause miscarriage, birth defects in the kidney, eye, brain,
gastrointestinal tract, or the limbs of the body. Babies whose mothers are
cocaine addicts tend to have low body weight and body length and head
circumference below normal. All of this is caused by local ischemia due to
narrowing of the arteries caused by cocaine. Children born to mothers who use
cocaine also seems to have a lower IQ, lack of attention and vigilance, as well
as disturbances in motor skills.
Some newborns may show withdrawal symptoms if the mother
used cocaine shortly before giving birth, but these symptoms are less frequent
and lighter than the symptoms of opioid withdrawal.
Opioids (eg, heroin, methadone and morphine) can pass
through the placenta. Opioids rarely causes birth defects, but the baby could
be born in a state of addiction. Withdrawal symptoms usually occur 6 hours to 8
days after birth, namely in the form of diarrhea, vomiting, stiffness in
muscles, irritability, rapid respiratory rate, and seizures.
The use of opioids during pregnancy also increases the risk
of complications during pregnancy, such as miscarriage, abnormal position of
the baby, and preterm delivery.
REFERENCE
- G, Ravindu. P, Avinash S. Drug Use During Pregnancy. Merck
Manual Handbook. 2013.
- J, Nicholas. Prenatal Drug Exposure. The Merck Manual.
2012.
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