Alcohol, Drugs and Medication in Pregnancy

Exposure to intrauterine drugs, alcohol and medicines can have profound effects on the child’s behaviour and propensity to behavioural disturbances. Some agents alter anatomic structure; others alter the chemical balance of neurotransmitters and may thus alter the regulation of brain function. This book documents the outcome and consequences for children exposed to intrauterine drugs, alcohol and medicine and explores strategies to support these children and those who care for them, including statutory agencies.

The international team of contributors sets out to inform the reader of the potential risks to infants exposed to a range of intrauterine chemicals that are potentially neuroactive, including medicinal drugs such as antiepileptics, antidepressants and antipsychotics, as well as drugs of abuse, including alcohol, opiates, and recreational drugs such as cannabis and tobacco. They review the teratogenic action of some of the chemical processes and the relationship of exposure to the stage of pregnancy.

In setting out the evidence for outcomes, the authors demonstrate that decisions about future care and management can and should be made early, with a secure understanding of the effect of this early exposure. This should allow professionals to provide protective management and prevent the delays in intervention and decision making that have so often been seen in this area of medical and social care.

• Demonstrates the consequences for the child of alcohol and drugs in pregnancy
• Includes chapters on the diagnosis and management of fetal alcohol syndrome
• Explores strategies to support affected children and those who care for them

Readership

Paediatricians, neonatologists, obstetricians, gynaecologists, child and adolescent psychiatrists and psychologists, those working in child care and child protection.

Clinics in Developmental Medicine No. 188

• AUTHORS’ APPOINTMENTS vii
• 1. INTRODUCTION 1
• Philip M Preece
• SECTION 1.
• NEUROTERATOGENESIS: EPIDEMIOLOGY AND PATHOLOGY
• 2. EPIDEMIOLOGY OF DRUG AND ALCOHOL USE DURING PREGNANCY 11
• Ron Gray
• 3. NORMAL AND ABNORMAL EMBRYOGENESIS OF THE MAMMALIAN BRAIN 23
• Kathy K Sulik, Shonagh K O‚ÄôLeary-Moore, Elizabeth A Godin
• and Scott E Parnell
• SECTION 2.
• LONG-TERM EFFECTS OF MAJOR PRESCRIBED MEDICATIONS
• 4. EPILEPSY IN PREGNANCY AND THE EFFECT OF PRENATAL ANTIEPILEPTIC MEDICATION 44
• Jill Clayton-Smith and Gus Baker
• 5. NEURODEVELOPMENT OF CHILDREN EXPOSED TO ANTIDEPRESSANT AND ANTIPSYCHOTIC MEDICATIONS DURING PREGNANCY 56
• Irene Nulman, Sara Citron, Michelle Todorow and
• Elizabeth Uleryk
• SECTION 3.
• LONG-TERM EFFECTS OF DRUGS OF ABUSE
• 6. DIAGNOSIS OF FETAL ALCOHOL SYNDROME: EMPHASIS ON EARLY DETECTION 85
• Margaret Barrow and Edward P Riley
• 7. THE EFFECTS OF PRENATAL ALCOHOL EXPOSURE ON BRAIN AND BEHAVIOUR 108
• Christie L McGee Petrenko and Edward P Riley
• 8.EFFECT OF DRUGS OF ABUSE ON THE FETUS: COCAINE AND OPIATES INCLUDING HEROIN 130
• Lynn T Singer and Sonia Minnes
• 9. CANNABIS USE DURING PREGNANCY: ITS EFFECTS ON
• OFFSPRING FROM BIRTH TO YOUNG ADULTHOOD 153
• Peter A Fried
• 10. IN UTERO EXPOSURE TO THE POPULAR ‘RECREATIONAL’ DRUGS
• MDMA (ECSTASY) AND METHAMPHETAMINE (ICE, CRYSTAL):
• PRELIMINARY FINDINGS 169
• Derek G Moore, John J D Turner, Julia E Goodwin, Sarah E Fulton, Lynn T Singer and Andrew C Parrott
• 11. THE SHORT-TERM AND LONG-TERM DEVELOPMENTAL CONSEQUENCES OF MATERNAL SMOKING DURING PREGNANCY 183
• Kate E Pickett and Lauren S Wakschlag
• SECTION 4.
• INTERVENTION STRATEGIES TO REDUCE THE IMPACT OF DRUGS AND
• ALCOHOL IN PREGNANCY
• 12. MANAGEMENT OF THE EFFECTS OF PRENATAL DRUGS IN CHILDREN OF DRUG-ABUSING PARENTS 197
• Faye Macrory and Michael Murphy
• 13. PRENATAL AND POSTNATAL INTERVENTION STRATEGIES FOR
• ALCOHOL-ABUSING MOTHERS IN PREGNANCY 217
• Ann P Streissguth and Therese M Grant
• 14. COGNITIVE AND BEHAVIOURAL INTERVENTIONS TO AMELIORATE THE EFFECTS OF FETAL ALCOHOL SPECTRUM DISORDERS IN CHILDREN AND ADOLESCENTS: PROMOTING
• POSITIVE OUTCOMES 234
• Wendy O Kalberg and Julie Gelo
• 15. FETAL TERATOGEN SYNDROMES: PSYCHIATRIC ASPECTS AND
• MANAGEMENT 252
• David J Bramble and Raja A S Mukherjee
• 16. RECOMMENDED MANAGEMENT OF COMMON MEDICAL PROBLEMS IN PREGNANCY: ADVICE FROM SPECIALIST AGENCIES 271
• Evelyne Jacqz-Aigrain and Philip M Preece
• INDEX 280
• COLOUR PLATE SECTION