Friday, November 30, 2012

Addiction and Pregnancy, Prof.F.Thibaut, Athens Conference

This doctor was a remarkable presenter of a very important topic.  (She not only provided a thorough and moving overview of the research but she also handled extremely well the many questions and positive comments that followed)

Addictions and Pregnancy
Professor F. Thibaut
University Hospital
INSERM, Rouen , France

Epidemiological data

Tobacco and Pregnancy
-25% of pregnant women smoke
-37% pregnant women smoke
-52% of pregnant women smoke

Alcohol and pregnancy
8-30% - 1 to 6% binge drinking
Australia - 14%
Russia 35%
Chile 57%
Ireland - 89% - 10% binge drinking
Sweden - 23 to 30% regularly
France - 53% not drinking
20-30% 1-4 drinks
14% 1 binge drinking episode during pregnance

Drugs and Pregnancy
USA 1996
 19% cannabis
5% daily
USA 2006
3 to41% 
4% cannabis, 2% cocaine, .3% both
Barcelona 2005
6% opioids, 3% cocaine, 1.5 % both
France 2006
3-10 % cannabis
3-5% cocaine

Consequences of exposure to children

Dose and pattern of use
Timing of exposure
Frequence and duration
metabolism of mother and infant

Consumption after delivery
Family environment - violence, personality disorders, psychiatric disorders

75% exposed versus 27% non exposed have medical problems at birth

Alcohol in utero

Fetal alcoholism
1.6 per thousand Sweden
2-7 per thousand USA
1-3 per thousand France
Fetal alcohol spectrum 1-5

FAS - 
Preventable mental retardation

45% of FAS go to committ crimes against persons

Tobacco in utero

Withdrawal at birth
-crying irritability, sleep and digestive disorders
 Cotinine in meconium or hair
-increased risk of sudden death
-growth impairment
-respiratory disorders
-cleft palate

  • cognitive disorders 
  • language impairment
  • dyscalculia
  • memory deficits, 
  • problem solving
  • attention deficit disorders
  • pscyhiatric disorders
  • addictive disorders

Cannabis in utero

Hypotrohy reduced head size
increased risk of sudden death
Withdrawal at birth ?
learnig impairments
Short term memory disorder
 language impairments
Attention disorders
psychiatric disorders - depression and anxiety

Cocaine in utero
in utero death
growht ipairment
Behaviour disorders

identification of at risk women

Addiction Severity Index
AUDIT, Fagerstrom, Cannabis Abuse Screen Tests
Mother’s consumption often underestimated by 2-3 factor

At Risk Women
low socioeconomic statu
low education
white women in us - alcohol and cannabis
black women in us - cocaine
psychiatric comorbidity


Avoidance of maternal consumption, tobacco, alcohol, drugs, during pregnancy is necessary

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