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
France
-25% of pregnant women smoke
Ireland
-37% pregnant women smoke
USA
-52% of pregnant women smoke
Alcohol and pregnancy
USA
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%
BRazil
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
Polyconsumption
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
Prematurity
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
cognitive
language
ADHD
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
polyconsumption
low socioeconomic statu
single
low education
white women in us - alcohol and cannabis
black women in us - cocaine
psychiatric comorbidity
Conclusion
Avoidance of maternal consumption, tobacco, alcohol, drugs, during pregnancy is necessary
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