Dangers of Drug Abuse in Pregnant Women

There are a lot of physiologic changes in pregnancy that can significantly alter the bio-availability of drugs taken orally. A higher dose is generally needed for pregnant patients with a few exceptions. Monitoring of doses is very important to make sure that there is no adverse effect to the mother and the fetus. Birth defects are the most common adverse effect of irresponsible drug consumption.

Contraindicated drugs

Abuse of these drugs may have teratogenic effects.

1. Erythromycin can cause acute cholestatic hepatitis in pregnant mother.
2. Metronidazole can cause mutation in the fetus.
3. Aminoglycosides can cause ototoxicity and ear problems.
4. Warfarin can result in facial dimorphism, nasal hypoplasia and defective bone mineralization in the fetus.
5. ACE inhibitors can cause renal dysgenesis in the fetus.
6. Live vaccines such as chicken pox, MMR and polio can cause vertical transmission to the fetus.

FDA Classification

The Food and Drug Administration (FDA) classify drugs as A, B and X, based on the drug safety for use in pregnancy.

Category A- these drugs demonstrated no fetal risk during controlled trials.

Category B- these drugs show no evidence of risk although they should be consulted with a doctor before consumption as abuser may have severe adverse effects.

Category X drugs- these drugs are absolutely contraindicated in pregnancy due to proven fetal risk.

Assessment of risk versus benefit is the main rule in drug prescribing for pregnant patients. Drug therapy should only be given when necessary, with the lowest possible dose and shortest possible duration, without compromising its therapeutic effect and the final decision should be made by a physician.