The table below summarises some of the risks associated with drug use during pregnancy:

Drug Risks
Smoking Increased risk of miscarriage (increased risk of around 47%)
Increased risk of pre-term labour
Increased risk of stillbirth
IUGR
Increased risk of sudden unexpected death in infancy
Alcohol Fetal alcohol syndrome (FAS)
• learning difficulties
• characteristic facies: smooth philtrum, thin vermilion, small palpebral fissures, epicanthic folds, microcephaly
• IUGR & postnatal restricted growthBinge drinking is a major risk factor for FAS
Cannabis Similar to smoking risks due to tobacco content
Cocaine Maternal risks
• hypertension in pregnancy including pre-eclampsia
• placental abruptionFetal risk
• prematurity
• neonatal abstinence syndrome
Heroin Risk of neonatal abstinence syndrome

Teratogens

The following table includes some of the drugs and medical conditions that may harm a developing fetus:

Drug/condition Effect
ACE inhibitors Renal dysgenesis, Craniofacial abnormalities
Alcohol Craniofacial abnormalities
Aminoglycosides Ototoxicity
Carbamazepine Neural tube defects, Craniofacial abnormalities
Valproate Neural tube defects, Craniofacial abnormalities
Chloramphenicol 'Grey baby' syndrome
Cocaine Intrauterine growth retardationPreterm labour
Diethylstilbesterol Vaginal clear cell adenocarcinoma
Lithium Ebstein's anomaly (atrialized right ventricle)
Maternal diabetes mellitus Macrosomia, Neural tube defects, Polyhydramnios, Preterm labour, Caudal regression syndrome
Smoking Preterm labour, Intrauterine growth retardation
Tetracyclines Discoloured teeth
Thalidomide Limb reduction defects
Warfarin Craniofacial abnormalities

Folic acid

Folic acid is converted to tetrahydrofolate (THF). Green, leafy vegetables are a good source of folic acid.

Functions

Causes of folic acid deficiency:

Consequences of folic acid deficiency:

Prevention of neural tube defects (NTD) during pregnancy: