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Prenatal tobacco, marijuana, stimulant, and opiate exposures: Outcomes and practice implications

Minnes, S., Lang, A., and Singer, L. – 2011

A review of the known effects of prenatal drug exposure on children, and effective treatment strategies for pregnant women. Discusses the negative impact of prenatal exposure to drugs on a child’s central nervous system, and notes that parental and environmental factors can also contribute to the impaired development of a drug-exposed child. Summarizes the negative effects of prenatal exposure to tobacco, such as low birth weight, excitability, and low IQ. Recommends behavioral interventions for pregnant smokers. Prenatal marijuana exposure does not seem to result in physical abnormalities, but some studies indicate emotional and behavioral problems in children. Recommends contingency management and cognitive-behavioral therapies for pregnant marijuana users. Prenatal exposure to cocaine can cause such problems as prematurity and neurobehavioral deficits. Older children exhibit attention and behavior problems. Brain abnormalities have been seen in scans. Prenatal exposure to methamphetamine can result in small size and lethargy. Contingency management therapy is a recommended treatment for pregnant stimulant users. Exposure to heroin can result in stillbirth and withdrawal. Methadone continues to be a widely-used treatment for pregnant heroin addicts. Recommended interventions for drug-exposed infants are home-based nursing services that improve parenting behavior, the home environment, and child development. Results of studies on foster care placement are mixed. Notes that intervention services addressing cognitive/behavioral problems should continue throughout childhood for drug-exposed children.