Drug use in pregnancy: parameters of risk.

With the increasing incidence of substance abuse in the United States, there has been a concomitant increase in the number of women becoming pregnant while using substances of abuse. The infant delivered to a drug-addicted woman is at risk for problems of growth and development as well as neonatal abstinence, and is also at increased risk of infections and exposure to HIV. The long-term outcome of these infants is influenced not only by the mother's use of illicit substances but by the frequent additional use of licit substances, such as cigarettes and alcohol. The drug-seeking environment in which many of these children are raised also may impair maximal development for these infants. In addition, many women from substance-abusing backgrounds lack a proper model for parenting and require intervention by the health care community to guide them in their roles as parents. Thus, multiple factors in the lives of these children, compounded by the early neurobehavioral deficits of drug-exposed newborns, earmark these infants to be at high risk for continuing developmental and later school problems.