Alcohol, Drugs and Medication in Pregnancy

The exposure of infants to the influence of intrauterine chemicals such as drugs and alcohol has a number of potential risks. The authors set out the evidence for these outcomes, and demonstrate that decisions about care and management can and should be made as early as possible. This should allow professionals to provide protective management and prevent the delays that are so often seen in this area of medical and social care. The international team of contributors cover a range of intrauterine chemicals that are potentially neuroactive, including medicinal drugs such as antiepileptics, antidepressants and antipsychotics, as well as drugs of abuse, including alcohol, opiates, and recreational drugs such as cannabis and tobacco. They review the teratogenic action of some of the chemical processes and the relationship of exposure to the stage of pregnancy. Some agents alter anatomic structure; others alter the chemical balance of neurotransmitters and may thus alter the regulation of brain function, with profound effects on the child's behaviour and propensity to behavioural disturbances. The book explores strategies to support these children and those who care for them, including statutory agencies.Contents1. INTRODUCTION 1Philip M PreeceSECTION 1.NEUROTERATOGENESIS EPIDEMIOLOGY AND PATHOLOGY2. EPIDEMIOLOGY OF DRUG AND ALCOHOL USE DURINGPREGNANCY 11Ron Gray3. NORMAL AND ABNORMAL EMBRYOGENESIS OF THEMAMMALIAN BRAIN 23Kathy K Sulik, Shonagh K O Leary-Moore, Elizabeth A Godinand Scott E ParnellSECTION 2.LONG-TERM EFFECTS OF MAJOR PRESCRIBED MEDICATIONS4. EPILEPSY IN PREGNANCY AND THE EFFECT OF PRENATALANTIEPILEPTIC MEDICATION 44Jill Clayton-Smith and Gus Baker5. NEURODEVELOPMENT OF CHILDREN EXPOSED TOANTIDEPRESSANT AND ANTIPSYCHOTIC MEDICATIONS DURINGPREGNANCY 56Irene Nulman, Sara Citron, Michelle Todorow andElizabeth UlerykSECTION 3.LONG-TERM EFFECTS OF DRUGS OF ABUSE6. DIAGNOSIS OF FETAL ALCOHOL SYNDROME: EMPHASIS ONEARLY DETECTION 85Margaret Barrow and Edward P Riley7. THE EFFECTS OF PRENATAL ALCOHOL EXPOSURE ON BRAIN ANDBEHAVIOUR 108Christie L McGee Petrenko and Edward P RileyvCONTENTS8. EFFECT OF DRUGS OF ABUSE ON THE FETUS: COCAINE ANDOPIATES INCLUDING HEROIN 130Lynn T Singer and Sonia Minnes9. CANNABIS USE DURING PREGNANCY: ITS EFFECTS ONOFFSPRING FROM BIRTH TO YOUNG ADULTHOOD 153Peter A Fried10. IN UTERO EXPOSURE TO THE POPULAR RECREATIONAL DRUGSMDMA (ECSTASY) AND METHAMPHETAMINE (ICE, CRYSTAL):PRELIMINARY FINDINGS 169Derek G Moore, John J D Turner, Julia E Goodwin, Sarah EFulton, Lynn T Singer and Andrew C Parrott11. THE SHORT-TERM AND LONG-TERM DEVELOPMENTALCONSEQUENCES OF MATERNAL SMOKING DURING PREGNANCY 183Kate E Pickett and Lauren S WakschlagSECTION 4.INTERVENTION STRATEGIES TO REDUCE THE IMPACT OF DRUGS ANDALCOHOL IN PREGNANCY12. MANAGEMENT OF THE EFFECTS OF PRENATAL DRUGS INCHILDREN OF DRUG-ABUSING PARENTS 197Faye Macrory and Michael Murphy13. PRENATAL AND POSTNATAL INTERVENTION STRATEGIES FORALCOHOL-ABUSING MOTHERS IN PREGNANCY 217Ann P Streissguth and Therese M Grant14. COGNITIVE AND BEHAVIOURAL INTERVENTIONS TOAMELIORATE THE EFFECTS OF FETAL ALCOHOL SPECTRUMDISORDERS IN CHILDREN AND ADOLESCENTS: PROMOTINGPOSITIVE OUTCOMES 234Wendy O Kalberg and Julie Gelo15. FETAL TERATOGEN SYNDROMES: PSYCHIATRIC ASPECTS ANDMANAGEMENT 252David J Bramble and Raja A S Mukherjee16. RECOMMENDED MANAGEMENT OF COMMON MEDICALPROBLEMS IN PREGNANCY: ADVICE FROM SPECIALIST AGENCIES 271Evelyne Jacqz-Aigrain and Philip M Preece