Substance use during pregnancy - care of the mother and newborn

Please note that some guidelines may be passed their review date. The review process is currently paused. It is recommended that you also refer to more contemporaneous evidence.

Following a recommendation from the state coroner, this topic has been made available via the Maternity eHandbook

Read the full topic: Substance use during pregnancy - care of the mother and newborn

Substance use in the mother may cause Neonatal Abstinence Syndrome (NAS) in a newborn. NAS is a syndrome of drug withdrawal observed in babies of women who are physically dependent on the drug during pregnancy; manifested by non- specific signs and symptoms including neurological excitability, gastrointestinal dysfunction, autonomic signs, poor weight gain, neuromuscular abnormalities and occasionally seizures (Women’s guideline, 2017).

NAS is more common in babies born to opioid-dependent women than in babies born to women dependant on other drugs. There is no dose-response relationship between maternal opioid intake and NAS. Onset of symptoms varies depending on the pharmacological properties of the substance used.

Babies of women dependent on alcohol or drugs may be at increased risk of harm and poor developmental outcomes due to complex interplay of psychosocial and environmental adversity. Assessment of risk of harm or neglect to the baby should occur throughout the pregnancy and postnatal period.