'Pregnancy: the Effects of Alcohol and Substance Abuse Essay\r'

'Abstract\r\nThis paper examined the effect of intoxi shadowtic b invariablyageic beverage and subject ab ex vitamin Ale on foetal phylogenesis in expecting m parvenue(prenominal)s. The critical currents of foetal evolution during maternal(p)ism ar reviewed and discussed in arrange of magnitude to fixate the set up inebriant and sum of money hindquarters take in during certain stages. In order to gain a a good deal efficient understanding of the effects diverse aggregates shag attain on foetal maturement the adjacent meanss were analyse: (1) alcoholic drinkic beverage, (2) cocaine, (3) opioids, (4) nicotine ( locoweed), and (5) marihuana sativa ( grassnabis). Each shopping mall (previously listed) examined was provided with supporting evidenced of past research.\r\n selective informational (i.e. material and intellectual) impairments were fix to be universal amongst the general nation of new born(p) infants and pip-squeakren let ond to a lcohol and drug nerve centers in utero. Use of alcohol and drug hearts during gestation non only put expecting m opposites own health at take a chance, but their foet characters as wellspring. Providing expecting gos with decent interposition for alcohol and warmheartedness phthisis has proven to be an good method in reducing the risk of impairing their foetus’s maturement (i.e. sensible, and mental) during pregnancy and later into peasanthood. It is inwrought to provide general aw argonness to the public just about the affects that alcohol and bosom exclaim cigargont cook on fetal outgrowth and economic aid big(predicate) women render comme il faut c atomic number 18.\r\nPregnancy: The Effects of alcoholic beverage and Substance exclaim on fetal increment today alcohol and mall abuse is continuing to out ripening across the general population, particularly among expecting experiences (Cohen & adenylic acid;Inaba, 2007). many an(prenominal) infants being born today substantiate from knockout somatogenetic, mental, and behavioural deformities and impairments due to alcohol and substance movie in utero (Cohen & antiophthalmic accompanimentor; Inaba, 2007). Research has been interminably conducted in order to examine the effects contrasting substances batch dedicate on a develop foetuses growth (i.e. physical, mental, and behavioral) in utero and later on pee-pee.\r\nThe majority of their findings c tout ensemble for a strong correlation in the midst of the time, pillow slip and amount of substances puzzles use during their pregnancy and the effects it has on their fetuses (Cohen & angstrom; Inaba, 2007). The purpose of this paper is to address these issues by dint of with(predicate) several(prenominal) different concepts: (a) first, what atomic number 18 the critical levels of development in utero?, (b) an in depth review on substances associated with fetal impairments (i.e. alcohol, cocaine, opio ids, nicotine, and mountainnabis sativa (marijuana)), supported by scientific evidence and come-at-able intercession, and (d) identifying substance abuse in expecting m opposites and reducing harm to the fetus.\r\nCritical Periods of Fetal education\r\nThe first critical result of fetal development is known as the root cell period. This begins when a sperm and egg unite and their genetic information is f utilise together (Office of Children’s wellness justification, 2003). During this period motion-picture show to any form of toxi drive outt substances (i.e. alcohol and drug substances) can potentially harm the semen cells development. This can spend a penny a send move on non only the m some other’s fertility, but withal her future infant’s health (Office of Children’s health Protection, 2003). aft(prenominal) the germ cells have developed past what is known as a single-cell zygote, they atomic number 18 now identify as a fetus (meaning they are adapted of maintenance outside of the drives womb) and have r for each oneed the embryonic and fetal period of development (Office of Children’s health Protection, 2003). The fetus grows change magnitudely fast during this period, be set about it is consider more(prenominal)(prenominal) vulnerable to environmental and substance depictions than during other stages of development (Office of Children’s health Protection, 2003). This is due to the fact that major organs are beginning to form, grow and develop, which go away continue passim the repose of the pregnancy and infancy (Office of Children’s wellness Protection, 2003).\r\n interruption of development (i.e. environmental toxins and substances) during this period can yard major defects in the structure of ontogeny organs (i.e. read/write interrogative sentence cellular structure, lungs, heart, kidney, and etc.), and other authorised structures (i.e. bones and muscles). This may re sult in the cobblers last of the fetus or slip severe physical malformations (i.e. congenital abnormalities) or mental impairments (i.e. disorders) (Office of Children’s Health Protection, 2003). As the stages of prenatal development progress, exposure to environmental toxins and substances can result in the fetus development an array of defects and deficiencies that can continue afterwards induce and up through adulthood (i.e. physical, mental, and behavioral) (Office of Children’s Health Protection, 2003).\r\nIt is clear that expecting mothers choose to be conscious of what they menace their fetuses to in utero so they develop correctly. It is imperative that expecting mothers subjugate the use of any alcohol or other drug substances during their pregnancy. Each period of development for a fetus is critical and exposure to alcohol and substances can significantly annul their chance of being born and living a healthy life (Office of Children’s Health Protection, 2003).\r\nThe Effects of Different Substances on Fetal Development\r\nExpecting mothers need to be cautious of what they expose their growing fetus to throughout the entire pregnancy. Disruption of proper fetal development can condition severe deformities in the fetus physically, mentally, and behaviorally (Cohen & group A; Inaba, 2007). Expecting mothers drive alcohol and drug substances leave their fetus nonresistant to severe developmental impairments (Cohen & vitamin A; Inaba, 2007). The following areas allow for be c all everywhereed in this section: (1) fetal exposure to alcohol, (2) fetal exposure to cocaine, (3) fetal exposure to opioids, (4) fetal exposure to nicotine, and (5) fetal exposure to marijuana sativa (marijuana).\r\nFetal image to Alcohol\r\nWhen expecting mothers consume alcohol they are immediately putting their fetus’s health at risk. Essentially they are difference their fetus susceptible to non only morphological deformities, but also a variety of fetal alcohol spectrum disorders (FASD) (Feldman, pg.76, 2011). Out of all of the FASDs, fetal alcohol syndrome (FAS) is the more or little common. Statistics indicate that over â€Å"0.33-2.9 cases per 1,000 contains have FAS” (Cohen & vitamin A; Inaba, 2007). FAS typically results in the fetus developing the following problems: (1) severe abnormalities in physical, neurological and behavioral public presentation and development, (2) severely reduced weight and cranium size, (3) deformities of the facet and other body parts (otherwise known as dysmorphia), and (4) are at higher(prenominal) risk for jerky Infant Death Syndrome (SIDS) (Feldman, pg.76, 2011). In essence exposure to alcohol can significantly affect a fetus internal and external body structure, can cause neurological and behavioral abnormalities, and even physical deformities. Research Kenneth Jones (1986) supports this assumption through his studies on FAS.\r\nJones (1986) findings allude that FAS effects the development of the fetus’s soul and facial/bodily structures during utero and after birth. typically children pass on be diagnosed with moderate to severe mental unhurriedness due to structural deformities in their the heading (i.e. microcephaly, shortsighted palpebral fissures, and etc.) or they arrest be place as having severe facial dysmorphia (i.e. long smooth philtrum, skimpy vermilion of the upper lip, joint anomalies, altered palmar crease pattern, and etc.) (Jones, 1986). Jones (1986) concluded that over 40% of infants who are born are born to alcoholic mothers, whom are then diagnosed with FAS. However, it is possible for refers to reduce the chances of children developing FAS and other FASDs through intervention forms of treatment. The majority of times children are more susceptible to developing FASD due to the doctors inability to clearly identify the expecting mothers level of beverage (Bakhireva & vitamin A; Savage, 2011 ).\r\nIf physicians are given the capability to identify expecting mothers unvarying deglutition patterns they can provide her with alternative methods to imbibinging and reduce the risk of her child develop an FASD (Bakhireva & axerophthol; Savage, 2011). Bakhireva &type A; Savage (2011) found that in identifying expecting mothers drinking levels, physicians would be able to detect the fetus’s risk for developing FASD and other neurobehavioral disorders later in life and prevent it. Bakhireva & Savage (2011) findings declare oneself that in that location are biomarkers that are more tippy to alcohol metabolism, which are capable of detecting the alcohol in tissue types for longer periods of time since the mother last drank. This will then assist physicians in diagnosing fetal alcohol exposure and possible damage to the fetus, which will then garter them do it what interference measures need to be taken. Developing new methods of detection and barroom of FASD is one of the roughly sound ways to encourage children quash severe developmental impairments. Expecting mothers also need to be informed of the damages that alcohol exposure can cause and seek the necessary care.\r\nFetal word-painting to Cocaine\r\nToday over 558,000 expecting mothers abuse cocaine (Cohen & Inaba, 2007). The case Survey on Drug Use and Health (NSDUH)(2005) cited by Cohen & Inaba (2007) determined that there was a â€Å"4% rate of cocaine use among women in their first trimester, 3% among those in their second trimester, and 2% among those in their third trimester”. Because of this expecting mothers need to become sure of how cocaine can affect their developing fetus. typically the stimulants in cocaine affect the fetus’s heart, which leads to blood vessel to constriction. This causes unhealthy elevations of blood public press in both the mother and fetus (Cohen & Inaba, 2011). For the fetus there life is put at great risk. This is b ecause the mother’s body will stop the flow of any blood, nutrients, or type O from reaching the fetus and can cause retarted fetal development or even a guessing within the fetus’s brain (Cohen & Inaba, 2007). This type of constriction can also increase the chances of the mother having a spontaneous abortion (due to the musical interval of the placenta from the uterine wall) or a premature saving (in more or less cases (typically the third trimester) cocaine can induce labor) (Cohen & Inaba, 2007). Even when an infant makes it through words the majority of them suffer from severe insularity symptoms.\r\nSigns of withdrawal typically consist of: (1) extreme agitation and irritability, (2) hyperactive movement and high respiratory rates, (3) seizures and tremors, and (4) uncontrollable eliminate and crying (Cohen & Inaba, 2007). Although physical deformities are common amongst the majority of substances infants are exposed do during utero, cocaine ha s been found to cause the most damage neurologically. typically children exposed to cocaine show an increase in â€Å"neurobehavioral disorganization, irritability, and low-down language development” (Cohen & Inaba, 2007). In fact researchers Brown, Bakeman, Coles, Sexson, & Demi (1998) analyze the effects of cocaine and alcohol exposure during utero on mother’s newborn infant’s and how it affected their birth weight, length, ponderal index, and irritability levels. Researchers found that exposed infants showed an increase in fetal growth deficits, infant orientation, and irritability and a decrease in respiratory rate and proper go development (only affected by cocaine exposure) (Brown, Bakeman, Coles, Sexson, & Demi, 1998).\r\nCocaine exposure clearly has a severe effect on fetal development. then it is essential that preventive techniques be discussed and reviewed for expecting mothers who are victimisation. vertical like alcohol use, there a re methods to exam expecting mothers for cocaine use. The most commonly employ methods are urine toxicology and serum toxicology, which helps detect â€Å"metabolite benzoylecgonine” (substance found in cocaine) from 72 hours to cardinal weeks after the mother has used (Bhuvaneswar, 2008). In the majority of states today it is mandatory for expecting mothers to be routinely screened for drug use during prenatal doctor visits.\r\nIn some states a positive render before delivery results in the arrest and immurement of the expecting mother (Bhuvaneswar, 2008). Most health care providers, however, have argued that women should be given proper drug counseling, mystical screening, and referral for treatment and case management rather than cruel penalties (Bhuvaneswar, 2008). That way expecting mothers can receive the necessary treatment to help make sure the fetus is not harmed anymore than it already has. Essentially when it comes to cocaine use, expecting mothers, and what preventive measures to take, proper screening and treatment are most effective in making sure a fetus develops properly and is born healthy.\r\nFetal Exposure to Opioids\r\nOpioids are the most common substance used by expecting mothers. Heroin and fixing agent are the two most abused. It is assumed that each year there are over 7000 opiate-exposed babies being born (Bhuvaneswar, 2008). Typically expecting mothers will continue to use opioids throughout their pregnancy. When expecting mothers use opioids it commonly takes less than one hour for the substance to reach the placental barrier. After only 6 hours it is common for not only the mother to survive withdrawal symptoms, but her fetus as well (Bhuvaneswar, 2008). As the mother goes through withdrawal the substance epinephrine may increase in the amnionic sacks fluid, which could cause severe damage to the growing fetus (Bhuvaneswar, 2008). Continued use of opioids throughout a pregnancy usually results in the following: (1) fetal growth retardation, (2) premature abruption of the placenta (which leads to premature delivery, spontaneous abortion, miscarriage, or cool itbirth), (3) neurobehavioral abnormalities (i.e. abnormal sleep patterns, behavioral problems, poor motor skills, development disorders, mental retardation, and others), and (4) greater risk for explosive Infant Death Syndrome (SIDS) (Cohen & Inaba, 2007).\r\nIn some cases opioid use can cause the infant to bang neonatal Abstinence Syndrome (NAS) (severe withdrawal after delivery). It can last from 48-72 hours to days, weeks, or even calendar months. It all depends on how much the mother exposed her infant to during utero (Cohen & Inaba, 2007). Symptoms of NAS are much more intense than an infant who may be withdrawing from nicotine or marijuana. When an infant is experiencing NAS they will exhibit the following characterisitcs: (1) extreme hyperactivity, agitation and irritability, (2) squeaking crying, sweating and tremors , (3) intense muscle spasms, (4) restlessness, (5) increased respiration, (6) vomiting, and diarrhea, and (7) severe seizures, which may lead to last (Cohen & Inaba, 2007). If an infant successfully makes is through withdrawal they are capable of being cleaned of any opioid substance that they were exposed to during utero.\r\n skillful as there are preventive measures for expecting mothers using alcohol or cocaine, there are preventive measures for mothers who use opiates. Today there are several clinical options for management of opiate use during pregnancy: (1) methadone maintenance, (2) the use of buprenorphine and naltrexone, and (3) opioid detoxification (usually done during the mothers second trimester) (Bhuvaneswar, 2008). Although not all risks to the fetus are eliminated with these types of treatment, the use of methadone, buprenorphine and naltrexone does help reduce the amount of spontaneous abortions and transmission of infections that opiate use usually causes (Bhu vaneswar, 2008). The main purpose of these methods is to essentially stop the mother from using altogether and reduce the chances of NAS when the child is born. If the expecting mother is able to detox and stop opiate use the chances of her child being born healthy is greater.\r\nFetal Exposure to Nicotine\r\nThere are over 2,000 different compounds that can be identified in one cigarette. disregarding of the many unhealthy substances contained in one cigarette, more than 17% of expecting mothers still flowerpot throughout their pregnancy (Cohen & Inaba, 2007). Cigarettes contain both nicotine and carbon dioxide. Which are two known compounds capable of crossing over the placental barrier during pregnancy and reducing the fetuses proviso of oxygen (Cohen & Inaba, 2007). However, restriction of oxygen to the fetus is only one concern. The expecting mother is also change magnitude her chances of having a premature delivery, miscarriage, or even a stillbirth. Nevertheless, premature births are the most common occurrences among expecting mothers who smoke (Cohen & Inaba, 2007). Infants who are born prematurely are abnormally small â€Å"on average they weigh, 7 ounces less, are 1.4 centimeters shorter, and have a smaller head circumference compared with babies of nonsmoking and non-drug-abusing mothers” (Cohen & Inaba, 2007). Although less common than exposure to other drug substances, smoking can cause a variety of defects.\r\nThe most typical are as follows: (1) congenital abnormalities (heart malformation, cleft lip/palate), (2) brain damage and nerve damage, (3) depressed immune establishment, (4) poor cognitive abilities (i.e. learning disabilities), and (5) increase chance of choppy Infant Death Syndrome (SIDS) (Cohen & Inaba, 2007). Typically though cognitive abilities are most likely to be impaired. In fact researcher Karen Law (2003) studied the effects nicotine exposure can have on a fetuses neurobehavioral development af ter birth. Law (2003) found that the infants who were exposed to nicotine during utero were more excitable and hypertonic and showed higher stress levels and abstinence signs when born. Shea & Steiners (2008) research on the effects of prenatal exposure to nicotine found the aforementioned(prenominal) results as Law (2003). Shea and Steiners (2008) findings indicated that the nicotine from cigarettes directly affects the fetus’s placental vasculature.\r\nThis can lead to cognitive and learning deficits in childhood and adolescents, increased risk of hypoxia induce brain damage, and an increased chance of perinatal deathrate or even sudden infant death syndrome (SIDS) (Shea & Steiner, 2008). Law (2003) and Shea and Steiner (2008) suggest that pregnant women need to avoid smoking during pregnancy in order to prevent serious impairments in neurodevelopment of their fetus. To the majority of expecting mothers exposing their fetuses to nicotine seems much less irresponsib le than if they were to expose them to a substance like cocaine or heroine. However, research shows that smoking can and will affect expecting mothers children. May be not to the same extent as cocaine or heroine, but to a point where your child will still be incapable of proper development. Fetal Exposure to Cannabis Sativa (marijuana)\r\nIt is verbalise that over 17% of expecting mothers smoke marijuana (Cohen & Inaba, 2007). around mothers condone their use of marijuana throughout their pregnancy, because it is said to help reduce pain when labor occurs. Many people would suggest that the majority of studies today mean that the use of marijuana during pregnancy causes only nominal side effects to the overall health of a fetus. Therefore, it is acceptable for mothers to use when pregnant. This is not true. Jutras-Aswad, DiNieri, Harkany, & Hurd, (2009) studied the use of marijuana during pregnancy and the affects it can have on the fetus during utero and after birth. R esearchers did this by examining the endocannabinoid (eCB) system and the effects it has on children’s behavior and mental health. Research indicated that eCB has a direct effect on the fetuses’ central nervous systems (CNS) patterning by influencing migration, survival, and differentiation of affiliated neurons.\r\nResearchers discovered that eCB affects the neuronal systems that control mood, cognition, reward, and goal tell behavior. This then effects the fetus’s brain development, which leaves them vulnerable to severe behavioral problems and neuropsychiatric disorders more so than others after birth. After reviewing this research it clear that marijuana can have a direct impact on the fetuses brain development (Jutras-Aswad, DiNieri, Harkany, & Hurd, 2009). Although the affects may not be apparent during a mother’s pregnancy, they are clearly identified later in infancy and childhood. In fact previous research conducted by Richardson, Day, and Goldschmidt (1995) studied the effects of marijuana use during pregnancy. Children who had been exposed to marijuana during utero were assessed repeatedly during the neonatal period until the age of six. Results indicated that prenatal marijuana exposure became apparent around ages four through six. There was an increase in children’s behavioral problems (i.e. affected their goal directed behavior, planning, organized search, and heart rate control) and a decrease in their performance on visual perceptual tasks, language comprehension, sustained attention, and retentiveness (Cohen & Inaba, 2007).\r\nThese findings support the theory that marijuana use during pregnancy can have an effect on children’s neurological development (Cohen & Inaba, 2007). So like many other drugs, it is strongly recommended that expecting mothers avoid the use of marijuana. Identifying & Providing Treatment for Substance Abuse in Expecting Mothers After reviewing the effects of a lcohol and other drug substances on fetal development it is lucid that expecting mothers need to abstain from substance use throughout their pregnancies. Rassool & Villar-Luis (2006) further support this assumption through their review on the effects that substance abuse can have on fetal development. Researchers identified several drug substances (i.e. alcohol, cocaine, opioids, nicotine, and cannabis) and found direct causes each substance has on expecting mother’s fetuses after birth. Researchers discovered the following primary concerns for each substance: (1) alcohol use can lead to fetal alcohol syndrome and possible miscarriage of the fetus, (2) cocaine, opioids, and nicotine can cause perinatal complications and unwanted abortions, and (3) cannabis sativa (marijuana) can cause perinatal complications (miscarriage), intrauterine growth restrictions, abruption placentae, pre-term deliveries, and neurobehavioral abnormalities.\r\nAfter reviewing each substance and p otential damage it can cause the Rassool & Villar-Luis (2006) suggest that different measures of prevention should be taken by expecting mothers to reduce the risk of harming their fetus. There are forms of prevention and treatment to help expecting mothers reduce the risk of harming their fetus’s development. The most efficient way to help expecting mothers find treatment is through using the necessary screening techniques in which physicians can identify alcohol or substance abuse (Cohen & Inaba, 2007). By insideng so physicians can provide proper intervention, treatment, and preventive services to substance abusing mothers (Cohen & Inaba, 2007).\r\nTypically expecting mothers who use drugs during pregnancy are classified as â€Å"AODs” (i.e. â€Å"pregnant women who use alcohol and other drugs”). The most commonly used instrumental role to identify AODs was developed by Dr. Ira Chasnoff (Cohen & Inaba, 2007). It is known as the 4Ps Plus Instr ument, which consists of four prefatorial questions that essentially help identify AODs (Cohen & Inaba,2007). The questions are listed below: 1.) Did either of your parents ever have a problem with alcohol or drugs? 2.) Does your partner have problem with alcohol or drugs? 3.) Have you ever drunk beer, wine, or liquor?\r\n4.) In the month before you knew you were pregnant, how many cigarettes did you smoke? In the month before you knew you were pregnant, how much beer, wine, or liquor did you drink? Once women with AOD are identified they can properly be treated in order to protect the mother and the growing fetus. Treatment may not seem effective once the expecting mother has already exposed her fetus to alcohol or other substances, but that is not true. Although the fetus is still at risk for some developmental damage it is still possible to stop any more from occurring if the mother stops using. Researchers Mayet, Morgan, MaCormack, & Strang (2008) have support for this assumption through their assessment of mothers who exposed their children to substances during utero and then proceeded to attend perinatal addiction treatment throughout the remainder of their pregnancy. Researchers administered a cross-sectional audit of health-care records in order to compare the outcomes of women in 2002â€2005 with data from 1989â€1991 and the local (i.e. non-substance abusing women) gestation period population in 2004â€2005.\r\nResearch found that less newborns required treatment for neonatal abstinence syndrome (NAS) in 2002â€2005 compared to 1989â€1991. However, there were higher rates of miscarriages, low birth weights, and premature infants, compared to the local maternity population between 2004â€2004. Findings suggest that perinatal addictions treatment can be extremely beneficial to mothers abusing substances. It lowers the risk of the mother harming her fetus by reducing the amount of drug substances she exposes her fetus to. It als o suggests that addiction treatments are becoming more evolved and are better servicing people compared to 1989-1991. In helping women become abstinent from substance use during their pregnancy it will help both them and their child live a healthier life during and after birth.\r\nConclusion\r\nIn conclusion, it is clear that alcohol and substance use is an increasing problem for the population of expecting mothers. As discussed in the paper the majority of expecting mothers are exposing their fetuses to the followings substances: (1) alcohol, (2) cocaine, (3) opioids, (4) cigarettes (nicotine), and (5) cannabis sativa (marijuana). Expecting mothers are unaware that they are putting their growing fetus at risk for severe developmental deformities and impairments (i.e. physical, mental, and behavioral) due to such exposure in utero and after birth. Not only that, but mothers are increasing their chances of premature deliveries, miscarriages, spontaneous abortions, and stillbirths. Ev en if their child makes it through delivery the majority of them experience severe Neonatal Abstinence Syndrome (NAS), Sudden Infant Death Syndrome (SIDS), or are born with disorders like fetal alcohol syndrome (FAS) (Cohen & Inaba, 2007).\r\nHowever, there are preventive measures that can be taken to avoid substance-abusing mothers risking their fetus’s developmental health. If physicians are able to identify expecting mothers substance use they will be able to give them proper a treatment and care. This will help reduce the chances of the mother impairing her fetus’s development any further (Cohen & Inaba, 2007). Mothers will also be able to get â€Å"clean” and plagiarise their child in a healthy environment. Although it may seem impossible, there are ways to help expecting mothers properly nourish their child back to health even when it comes to substance abuse.\r\nReferences\r\nBakhireva, L. N., & Savage, D. D. (2011). Focus on: Biomarkers of f etal alcohol exposure and fetal alcohol effects. Alcohol Research & Health, 34(1), 56-63. Bhuvaneswar, Chaya (2008). Cocaine & opioid use during pregnancy: Prevalence & Management. inflorescence Care Companion J. clinical Psychiatry. 10(1): 59â€65. Brown, J. V., Bakeman, R., Coles, C. D., Sexson, W. R., & Demi, A. S. (1998). Maternal drug use during pregnancy: be preterm and full-term infants affected differently?. Developmental Psychology, 34(3), 540-554. inside:10.1037/0012-1649.34.3.540 Cohen, W.E., & Inaba, D.S. (2007). Uppers, downers, all arounders (6th ed.). Medford, OR: CNS publications, Inc. Feldman, R. S. (2011). Development across the life span (6th ed.). Upper attach River, NJ: Pearson/Prentice Hall. ISBN:0558937071. Jones, K.L. (1986). Fetal alcohol syndrome. division of paediatrics; 8:122-126. Jutras-Aswad, D., DiNieri, J. A., Harkany, T., & Hurd, Y. L. (2009). Neurobiological consequences of maternal cannabis on human fetal development and its neuropsychiatric outcome. European Archives Of Psychiatry And Clinical Neuroscience, 259(7), 395-412. doi:10.1007/s00406-009-0027-z Law, K.L. (2003). Smoking during pregnancy and newborn neurobehavior. Pediatrics Vol. 111: 1318-1323. Mayet, S., Groshkova, T., Morgan, L., MacCormack, T., & Strang, J. (2008). Drugs and pregnancyâ€Outcomes of women engaged with a specialist perinatal outreach addictions service. Drug And Alcohol Review, 27(5), 497-503. doi:10.1080/09595230802245261 Rassool, G., & Villar-Luís, M. M. (2006). Reproductive risks of alcohol and illicit drugs: An overview. Journal Of Addictions Nursing, 17(4), 211-213. doi:10.1080/10884600600995242 Shea, A. K., & Steiner, M. (2008). Cigarette smoking during pregnancy. Nicotine & baccy Research, 10(2), 267-278. doi:10.1080/14622200701825908 The\r\nOffice of Children’s Health Protection (2003).Critical periods in development. 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