Perinatal Substance Use

Progesterone Reduces the Use of Cocaine in Postpartum Women with Cocaine Use Disorder

It has been suggested in prior literature that the effects of cocaine are partially modulated by the gonadal hormones, estradiol and progesterone, which may account for sex differences in the use and abuse of cocaine (Evans et al. 2002 & Jackson et al. 2006). Because previous studies have shown that women who use cocaine tend to use less of this drug during periods of high endogenous progesterone levels, as in pregnancy or during the luteal phase of the menstrual cycle, a recent study explored whether progesterone replacement could be effective in reducing cocaine use in postpartum women with a cocaine use disorder.  In this recent double-blinded study performed by researchers at Yale School of Medicine, women were eligible for the study if they met DSM IV criteria for cocaine abuse or dependence in the 6 months prior to conception or during pregnancy and were within 12 weeks of delivery.

By |2015-02-13T12:09:29-04:00February 4th, 2015|Cocaine, Hormone Therapy, Perinatal Substance Use, Prevention|Comments Off on Progesterone Reduces the Use of Cocaine in Postpartum Women with Cocaine Use Disorder

Opioid Abuse and Dependence in Pregnancy: Impact on Obstetrical Outcomes

In a recent study, researchers looked at the rising nationwide trend of opioid abuse and dependence in pregnancy and obstetrical outcomes in this patient population.  Previous research has focused on neonatal outcomes, such as neonatal abstinence syndrome; however, maternal complications have not been well-studied.  In this study, data was collected from the Nationwide Inpatient Sample (NIS), including nearly 57 million American women who were admitted for obstetric delivery between the years 1998-2011.  Overall 113,105 of those women (0.2%) were identified as abusing or being dependent on opioids.  The prevalence increased by 127% from the beginning of the study in 1998 until its completion in 2011, reflecting the growing opioid epidemic.   The increase was mostly represented in women 20 to 34 years or age.

By |2015-02-13T10:11:40-04:00January 22nd, 2015|Opioids, Perinatal Substance Use|Comments Off on Opioid Abuse and Dependence in Pregnancy: Impact on Obstetrical Outcomes

Smoking While Pregnant: What are the Effects on the Developing Fetal Brain?

When women come to us for consultation, we focus primarily on the risks of exposure to psychotropic medications. It is important, however, to consider the impact of other, potentially harmful, exposures that are common in [...]

By |2014-08-13T10:51:57-04:00August 18th, 2014|Nicotine, Outcomes, Perinatal Substance Use, Pregnancy Outcomes|Comments Off on Smoking While Pregnant: What are the Effects on the Developing Fetal Brain?

Pregnancy and Marijuana: How Much Do We Really Know?

With many states now considering the legalization of medical marijuana, there seems to be a growing sense that marijuana is relatively safe and may, in some cases, be more attractive or effective than traditional pharmacologic interventions.  We have witnessed this shift in attitude in our clinic, where many of our clinicians have been surprised to hear women ask questions about the dangers of using antidepressants and other medications during pregnancy while at the same time feeling relatively comfortable with their use of marijuana in the same setting.

By |2014-05-15T17:09:26-04:00May 15th, 2014|Cannabis, Outcomes, Perinatal Substance Use|Comments Off on Pregnancy and Marijuana: How Much Do We Really Know?

Facilitating Smoking Cessation in Pregnant Women: An Innovative Web-Based Training for Healthcare Professionals

Women who smoke during pregnancy are at greater risk for certain complications, including placental previa, placental abruption, and premature rupture of the membranes, and premature delivery.  Furthermore, infants of mothers who smoke during pregnancy are more likely to be small for gestational age and are at greater risk of sudden infant death syndrome (SIDS).

By |2015-08-10T15:42:16-04:00October 27th, 2012|Nicotine, Perinatal Substance Use, Prevention|Comments Off on Facilitating Smoking Cessation in Pregnant Women: An Innovative Web-Based Training for Healthcare Professionals

Worse outcomes in Infants Exposed to MDMA (Ecstasy) during Pregnancy

3,4-methylenedioxymethamphetamine (MDMA) or “Ecstasy” is one of the most widely used illicit recreational drugs among young adults. This report indicates that infants exposed to Ecstasy ad other recreational drugs may have delays in their motor development.

By |2015-08-12T16:27:24-04:00May 19th, 2012|Child Outcomes, Outcomes, Perinatal Substance Use|Comments Off on Worse outcomes in Infants Exposed to MDMA (Ecstasy) during Pregnancy

No Safe Level of Alcohol Use in Pregnancy

Reduced birth length and weight, microcephaly, and characteristic facial deformities (smooth philtrum and thin vermillion border) are associated with alcohol exposure during the second half of the first trimester and are dose-related.  In this prospective study including 992 subjects, there was no evidence of a threshold, indicating that women should be advised to abstain from alcohol consumption from conception throughout pregnancy.

By |2015-08-12T16:50:33-04:00March 12th, 2012|Alcohol, Outcomes, Perinatal Substance Use|Comments Off on No Safe Level of Alcohol Use in Pregnancy
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