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Pregnant women should be screened for substance abuse, psychiatrist tells international congress on obstetrics and gynaecology

News 20 March 2017

Nearly two in 10 (19.6%) women in the Western Cape, South Africa drink alcohol while pregnant*; twice the international average and more than double the number in the US (8.5%)**. Meanwhile, statistics show that almost 9% of expectant mothers in South Africa use illegal drugs*, compared to 6% in the US** where nearly 16% of women smoke cigarettes during pregnancy**. With women most at risk of developing a substance use disorder during their reproductive years (especially between 18-29), experts insist greater awareness and further action are needed to better manage this critical issue. 

The management and treatment of substance abuse in pregnancy was debated at the Royal College of Obstetricians and Gynaecologists (RCOG) World Congress which took place from 20-22 March 2017. More than 2,000 delegates from around the world registered to attend the event at the Cape Town International Convention Centre. Dr Kerry Louw, a psychiatrist at Stikland Hospital in Cape Town, joined more than 155 internationally renowned experts to discuss issues affecting women’s healthcare globally. Her presentation, Substance abuse in pregnancy: The medical challenge, highlighted the need to screen pregnant women for substance use as the misuse of alcohol, nicotine, cannabis, stimulants and opiates can lead to serious health complications for both the mother and baby. 

Dr Kerry Louw, psychiatrist at Stikland Hospital, said:

“Globally, nicotine is the most commonly used drug in pregnancy followed by alcohol, cannabis and cocaine. While any substance use during pregnancy can have potentially serious effects on the health of the mother and unborn baby, the repercussions depend on the drug, concurrent chemical usage, timing and extent of use, co-occurring psychiatric illnesses and environmental factors. 

“Substance use in pregnancy can lead to multiple health problems such as poor fetal development, low birth weight, prematurity, fetal alcohol syndrome, miscarriage and stillbirth. After the birth, substance abuse can affect mother-baby bonding and parental functioning. It can also trigger gender-based and domestic violence, which may impact the physical, emotional and mental development of the child. 

“As about half of all pregnancies are unplanned, many women continue to use substances before realising they’re pregnant. While many women are able to use their pregnancy as motivation to stop using substances, cut down or seek help from healthcare professionals or support groups, the chronic and relapsing nature of substance use disorders mean that some women are unable to quit. For those who do manage to achieve abstinence during pregnancy, rates of relapse are high within the first six months post-partum.

“While substance use in pregnancy has been a long-standing issue, concern intensified in the 1960s and 1970s after the prescription of teratogenic substances such as Thaliodomide, led to birth defects. Recently, there has been a spike in opiate use in pregnancy, with the US reporting a five-fold increase between 2000 and 2009***. Although several national guidelines have since been developed to help healthcare professionals identify and manage substance use disorders in pregnancy, effective treatments are limited and further research is needed.” 

NOTES:

Women’s right to receive safe and timely healthcare were the focus of the 2017 Royal College of Obstetricians and Gynaecologists (RCOG) World Congress in Cape Town from 20-22 March. The cutting edge scientific programme of daily plenary sessions and simultaneous lectures also featured presentations from experts including:

  • Atul Gawande – The checklist effect: From surgery to childbirth
  • Ariadne Labs – The impact of the BetterBirth trial on birth practices, maternal mortality and morbidity, and newborn mortality
  • Mitchell Besser – Mothers-to-mothers to be: How we changed the impact of HIV on African women and children
  • Rob Norman – Obesity and under nutrition in reproduction
  • Roger Lobo – Menopause Hormone Therapy – The window of opportunity
  • Michael Pepper – Gender and sexual diversity
  • Naeemah Abrahams – Gender-based violence: Is there light at the end of the tunnel
  • Josephine Kulea, Janice Rymer and Seynabou Tall – FGM: Community advocacy and mandatory reporting – conversation about different approaches to the same problem 
  • Margaret Kenyatta, First Lady of Kenya

For more information or a copy of the Congress programme, please visit www.rcog2017.com

International media inquiries: 
Eclipse Public Relations – Kirsten Smith 082 820 3920 / info@eclipsepr.co.za

UK media inquiries:
RCOG – Tara Meakins 0207 772 6357 / 07715 677 224 / pressoffice@rcog.org.uk

The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.

* Petersen Williams P, Jordaan EX, Mathews C, Lombard C, Parry CDH. Alcohol and Other Drug Use during Pregnancy among Women Attending Midwife Obstetric Units in the Cape Metropole, South Africa. Advances in Preventive Medicine. 2014;2014(1):1–10. doi:10.1155/2014/871427.

** Forray A. Substance use during pregnancy. F1000Research. 2016;5:887. doi:10.12688/f1000research.7645.1.

*** Patrick et. Al., JAMA 2012, Patrick et. Al., Journal of Perinatology 2015