Maternal / Fetal / Neonatal Effects of Alcohol and
Other Drugs Commonly Used by Pregnant Women
Drug Name
(various forms)
Maternal
Effects
Fetal
Effects
Neonatal/Infant
Effects
Long-term
Effects
Alcohol/ ethanol
Tolerance;
intoxication;
central nervous system
(CNS) depression;
withdrawal; risk for
seizures; and damage
to liver, heart,
stomach, etc.
Possible
abnormalities in
growth and
development;
brain damage
Fetal Alcohol
Syndrome/Fetal
Alcohol Spectrum
Disorders
Mental retardation,
developmental delays,
lower IQ
(Hard liquor, beer,
wine, wine coolers,
etc.)
Alcohol
withdrawal may cause
hypertension,
tachycardia, and
premature labor.
Constriction of blood
flow to placenta
hinders delivery of
nutrients and oxygen
Possible Fetal Alcohol
Syndrome or Fetal
Alcohol Spectrum
Disorders
Malnutrition
Three major
characteristics:
 Growth retardation
 Central nervous
system abnormalities
including
developmental and
mental retardation
 Structural
abnormalities
including
characteristic facial,
skeletal, and organ
defects
Possible learning
disabilities;
attention deficits;
hyperactivity;
problems with impulse
control, language,
memory, and social
skills
Possible CNS depression and withdrawal,
with irritability,
restlessness, agitation,
and increased risk of
neonatal mortality;
poor feeding.
Marijuana/
Tetra-hydrocannabinol (THC)
CNS depression, but
can act as a stimulant;
toxic to respiratory
system and immune
system.
Increased heart rate,
hypotension
Labor and delivery
complications
including prolonged or
arrested deliveries,
abnormal bleeding,
meconium staining,
etc.
THC use may impair
sperm production in
males.1
Shorter gestation, some
congenital anomalies1
Frequent use may be
associated with low
birth weight2,3
Possible neurological
abnormalities resulting
from CNS immaturity:
 Abnormal responses
to light and visual
stimuli
 Tremulousness
 High-pitched cry4
Possible long-term
effects include
increased childhood
depression; initiation
and frequency of
marijuana use by age
14; memory deficits;
increased hyperactivity, impulsivity,
inattention symptoms,
and delinquency 5-8
Maternal/Fetal/Neonatal Effects of Alcohol and Other Drugs
Drug Name
(various forms)
Maternal
Effects
Fetal
Effects
Neonatal/Infant
Effects
Long-term
Effects
Prescription
sedativehypnotics
Tolerance, CNS
depression
Drug accumulates in
fetus at greater levels
than in mother1
Long-term effects not
known
Low birth weight10
Drug and metabolites
may remain in
newborn for days or
weeks longer than in
the mother. May result
in lethargy, poor
muscle tone, sucking
difficulties, or even
CNS depression1
Increased risk for cleft
lip or palate11
Withdrawal may
occur11
(e.g., Valium, Xanax,
Halcion, etc.)
Respiratory
depression1
Acute withdrawal with
risk of premature
labor9,10
Fetal depression,
abnormal heart rhythm
or even death1
Increased risk for
hypoglycemia and
respiratory problems10
Amphetamines/
Stimulants
CNS and
cardiovascular
stimulation:
 increased heart rate
 increased blood
pressure
 vascular constriction
Anorexia, weight loss,
insomnia
Possible growth
retardation and fetal
hypoxia
Possible withdrawal or
intoxication
Long-term effects not
known
Low birth weight13
Possibility of cleft lip
and palate, intrauterine
fetal demise, fetal
distress, and placental
abruption12
Adequate studies
lacking
Decreased blood flow
to placenta
Risk of HIV/AIDS
with intravenous use12
Cocaine, crack
cocaine
CNS and cardiovascular stimulation:
 increased heart rate
 increased blood
pressure
 vascular constriction
Pregnancy associated
with increased
sensitivity to cocaine12
Growth retardation3;
many children experience catch-up growth
and are normal weight
by 6-12 months14
Fetal hypertension and
distress12
Risk for intrauterine
stroke1
Intoxication and/or
withdrawal. Symptoms
may include:
 irritability/agitation
 increased tone
 tremors
 jitters
 inconsolability
 increased respiration15
Possible developmental delays
Possible long-term
deficits in attention and
learning17
Possible risk for
seizures16
Adapted from SAMHSA/CSAP Technical Report, No. 7, 1993. Institute for Health and Recovery, 2009
Maternal/Fetal/Neonatal Effects of Alcohol and Other Drugs
Drug Name
(various forms)
Maternal
Effects
Fetal
Effects
Neonatal/Infant
Effects
Cocaine, crack
cocaine
(continued)
Decreased blood flow
to placenta
Possible genito-urinary
abnormalities
Slower drug excretion
in newborn
Possible placental
abruption and bleeding
Necrotizing
enterocolitis1
Abnormal sleep and
ventilatory patterns1
Tolerance, CNS
depression
Intrauterine growth
retardation
Risk for HIV/ AIDS
and other infections
with injection drug use
Risk of HIV/AIDS
infection from mother
Addiction and
Neonatal Narcotic
Withdrawal Syndrome.
Symptoms may
include:
 hyperactivity
 irritability/agitation
 high-pitched cry
 increased neuromuscular tone
 tremors
 seizure risk
Long-term
Effects
Premature labor3,12
Possible growth
retardation and fetal
hypoxia12
Heroin, opiates
Low birth weight3
Malnutrition
12
Acute withdrawal and
risk for spontaneous
abortion or premature
labor18
Possible long-term
neurobehavioral
deficits
Poor feeding
Abnormal sleep and
ventilatory patterns
HIV/AIDS risk19
Growth retardation
Cigarettes
(nicotine and
other compounds
in smoke)
CNS stimulation and
respiratory damage
Reduced fetal oxygen
supply
Smaller head circumference23
Impaired fetal growth20
Increased risk for fetal
distress, fetal demise,
spontaneous abortion,
and premature
labor21,22
Prenatal cessation
reduces risk of preterm birth and delivering small for gestation
age neonates24
Abnormal nursing
Possible increase in
disruptive behavior,
oppositional defiant
disorder, and serious
delinquency26
Increased risk of
asthma27
Possible impairment of
language
development28
Risk for congenital
palate and heart
defects25
Adapted from SAMHSA/CSAP Technical Report, No. 7, 1993. Institute for Health and Recovery, 2009
Maternal/Fetal/Neonatal Effects of Alcohol and Other Drugs
This document has been adapted from Pregnancy and Exposure to Alcohol and Other Drug Use.
CSAP Technical Report, No. 7, published in 1993 by the Substance Abuse and Mental Health
Services Administration, Center for Substance Abuse Prevention. Wherever possible, we have
updated the references to reflect more current trends in research.
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Substance Abuse and Mental Health Services Administration, Center for Substance Abuse
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Adapted from SAMHSA/CSAP Technical Report, No. 7, 1993. Institute for Health and Recovery, 2009