Therapeutic Drugs, Recreational Drugs and Lifestyle Factors

  • Frank D. Johnstone
  • David C. Howe


Fetal growth is necessarily the result of genetic potential modified by exposure to environmental factors. The fetal environment is of course dictated entirely by maternal physiology, but this in turn is dependent upon the environment to which the mother is exposed. Drugs ingested by the mother are an obvious environmental agent with the potential to affect fetal growth either directly through toxic actions on proliferating cells, or indirectly by altering placental transfer of oxygen and metabolic substrate. In the broadest sense, however, environmental factors might encompass maternal lifestyle and a wide range of variables that are often difficult to precisely define and quantify. For example, low socioeconomic status is linked to many indices of poor health and it is perhaps not surprising that it has been suggested to be linked to low birthweight. Associated with low socioeconomic status there may be poor nutritional intake and higher rates of cigarette smoking, and of teenage pregnancy and high parity, all of which potentially influence fetal growth. Teasing out the important variables is often difficult. This chapter focuses on a number of therapeutic and recreational drugs linked with IUGR, and closes with a consideration of certain aspects of maternal lifestyle that have been suggested to be associated with it.


Obstet Gynecol Fetal Growth Congenital Adrenal Hyperplasia Maternal Smoking Passive Smoking 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Seckl JR, Miller WL. How safe is long-term prenatal glucocorticoid treatment? JAMA 1997;277:1077–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Sun K, Yang K, Challis JRG. Glucocorticoid actions and metabolism in pregnancy: Implications for placental function and fetal cardiovascular activity. Placenta, 1998;19:353–60.PubMedCrossRefGoogle Scholar
  3. 3.
    Nathanielsz PW, Comline RS, Silver M, Paisey RB. Cortisol metabolism in the fetal and neonatal sheep. 1972 J Reprod Fertil Suppl;16:39–59.PubMedGoogle Scholar
  4. 4.
    Pepe GJ, Waddell BJ, Albrecht ED. Activation of the baboon fetal hypothalamic-pituitary-adreno- cortical axis at midgestation by estrogen-induced changes in placental corticosteroid metabolism. 1990 Endocrinology;127:3117–3123.PubMedCrossRefGoogle Scholar
  5. 5.
    Crowley P, Chalmers I, Keirse MJNC. The effects of corticosteroid administration before preterm delivery: an overview of the evidence from controlled trials. Brit J Obstet Gynaecol 1990;97:11–25.CrossRefGoogle Scholar
  6. 6.
    Crowley PA. Antenatal corticosteroid therapy: a meta-analysis of the randomised trials, 1972 to 1994. Am J Obstet Gynecol 1995;173:322–35.PubMedCrossRefGoogle Scholar
  7. 7.
    Forest MG, Morel Y, Dard M. Prenatal treatment of congenital adrenal hyperplasia. Trends Endocrinol Metab 1998;9:284–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Ostesen M. Optimisation of antirheumatic drug treatment in pregnancy. 1994 Clin Pharmacokinetics; 27:486–503.CrossRefGoogle Scholar
  9. 9.
    Reinisch JM, Simon NG, Karow WG. Prenatal exposure to predisone in humans and animals retard intrauterine growth. Science, 1978;202:436–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Katz VL, Thorp JM, Bowes WA. Severe symmetric intrauterine growth retardation associated with the topical use of triamcinolone. Am J Obstet Gynecol 1990;162:396–7.PubMedGoogle Scholar
  11. [Anonymous] NIH Consensus Conference: Effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1995;273:413–18.Google Scholar
  12. 12.
    Ballard PL, Ballard RA, Scientific basis and therapeutic regimes for uses of antenatal glucocorticoids. Am J Obstet Gynecol 1995;173:254–62.PubMedCrossRefGoogle Scholar
  13. 13.
    Johnson JWC, Mitzner W, London WT, Palmer AE, Scott R, Kearney K. Glucocorticoids and the rhesus fetal lung. Am J Obstet Gynecol 1978;130:905–15.PubMedGoogle Scholar
  14. 14.
    Johnson JWC, Mitzner W, London WT, Palmer AE, Scott R. betamethasone and the rhesus fetus: multisystemic effects. Am J Obstet Gynecol 1979;133:677–84.PubMedGoogle Scholar
  15. 15.
    Bunton TE, Plopper CG. Triamcinolone-induced structural alterations in the development of the lung of the fetal rhesus macaque. Am J Obstet Gynecol 1984;148:203–15.PubMedGoogle Scholar
  16. 16.
    Epstein MF, Farrell PM, Sparks JW, Pepe G, Driscoll SG, Chez RA. Maternal betamethasone and fetal growth and development in the monkey. Am J Obstet Gynecol 1977;127:261–3.PubMedGoogle Scholar
  17. 17.
    Benediktsson R, Lindsay RS, Noble J, Seckl JR, Edwards CRW. Glucocorticoid exposure in utero: new model for adult hypertension. Lancet, 1993;341:339–41.PubMedCrossRefGoogle Scholar
  18. 18.
    Ikegami M, Polk DH, Jobe AH, Newnham J, Sly P, Kohan R, Kelly R. Effect of interval from fetal corticosteroid treatment to delivery on postnatal lung function of preterm lambs. J Appl Physiol 1996;80:591–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Dodic M, May CN, Wintour EM, Coghlan JP. An early prenatal exposure to excess glucocorticoid leads to hypertensive offspring in sheep. Clinical Science 1998;94:149–155.PubMedGoogle Scholar
  20. 20.
    Jobe AH, Wada N, Berry IM, Ikegami M, Ervin MG. Single and repetitive maternal glucocorticoid exposures reduce fetal growth in sheep. Am J Obstet Gynecol 1998;178:880–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Sanfacon R, Possmayer F, Harding PGR. Dexamethasone treatment of the guinea pig fetus: its effects on the incorporation of 3H-thymidine into deoxyribonucleic acid. Am J Obstet Glynecol 1977;127:745–52.Google Scholar
  22. 22.
    Liggins GC. Adrenocortical-related maturational events in the fetus. Am J Obstet Gynecol 1976;126:931–9.PubMedGoogle Scholar
  23. 23.
    Langley-Evans SC, Phillips GJ, Benediktsson R, Gardner DS, Edwards CRW, Jacobs AA, Seckl JR. Protein intake in pregnancy, placental glucocorticoid metabolism and the programming of hypertension in the rat. Placenta, 1996;17:169–72.PubMedCrossRefGoogle Scholar
  24. 24.
    Fowden AL, Szemere J, Hughes P, Gilmour RS, Forhead AJ. The effects of Cortisol on the growth rate of the sheep fetus during late gestation. J Endocrinol 1996;151:97–105.PubMedCrossRefGoogle Scholar
  25. 25.
    Dietrich JW, Canalis EM, Maina DM, Raisz LG. Effects of glucocorticoids in fetal rat bone collagen synthesis in vitro. Endocrinology, 1979;104:715–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Nogami H, Tachibana T. Dexamethasone induces advanced growth hormone expression in the fetal rat pituitary gland in vivo. Endocrinology 1993;132:517–23.PubMedCrossRefGoogle Scholar
  27. 27.
    Sara VR, Hall K. Insulin-like growth factors and their binding proteins. Physiol Rev 1990;707:591–614.Google Scholar
  28. 28.
    Li J, Saunders JC, Gilmour RS, Silver M, Fowden A. Insulin-like growth factor-II messenger ribonucleic acid expression in fetal tissues of the sheep during late gestation: effects of cortisol. Endocrinology, 1993;132:2083–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Sensky PL, Roy CH, Barnes RJ, Heath MF. Changes in fetal thyroid hormone levels in adrenalec- tomised fetal sheep following continuous Cortisol infusion 72 h before delivery. J Endocrinol 1994;140:79–83.PubMedCrossRefGoogle Scholar
  30. 30.
    Davison JM. Pregnancy in renal allograft recipients: problems, prognosis and practicalities. Bailliere’s Clin Obstet Gynaecol 1994;8:501–25.CrossRefGoogle Scholar
  31. 31.
    Baxi, JV, Rho, BB. Pregnancy after cardiac transplantation. Am J Obstet Gynecol 1993;169:33–4.PubMedGoogle Scholar
  32. 32.
    Vile Y, Fernandez H, Samuel D, Bismuth H, Frydman R. Pregnancy in liver transplant recipients: course and outcome in 19 cases. Am J Obstet Gynecol 1993;168:896–902.Google Scholar
  33. 33.
    Pickerell MD, Sawers R, Michael J. Pregnancy after renal transplantation: severe intrauterine growth retardation during treatment with cyclosporin A. BMJ 1988;296:825.CrossRefGoogle Scholar
  34. 34.
    Haugen G, Fauchald P, Sodai G, Leivestad T, Moe N. Pregnancy outcome in renal allograft recipients, influence of cyclosporin A. Eur J Obstet Gynaecol 1991;39:25–9.CrossRefGoogle Scholar
  35. 35.
    Davison JM, Redman CWG. Pregnancy post-transplant: the establishment of a UK registry. Br J Obstet Gynaecol 1997;104:1106–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Armenti VT, Ahlswede KM, Ahlswede BA, Jarrell BE, Moritz MJ, Burke JF. National transplantation pregnancy registry-outcomes of 154 pregnancies in cyclosporin-treated female kidney transplant recipients. Transplantation, 1994;57:502–6.PubMedGoogle Scholar
  37. 37.
    Fletchner SM, Karz AR, Rogers AJ, Van Buren C, Kahan BD. The presence of cyclosporin in body tissues and fluids during pregnancy. Am J Kidney Dis 1985;5:60–3.Google Scholar
  38. 38.
    Derfler K, Schaller A, Herold C, Balcke P, Nowotny C, Walter R, Kopsa H, Endler M, Stockenhuber F, Kletter K. Successful outcome of a complicated pregnancy in a renal transplant recipient taking cyclosporin A. Clin Nephrol 1988;29:96–102.PubMedGoogle Scholar
  39. 39.
    Biesenbach G, Zazgornik J, Kaiser W, Stoger H, Derfler K, Balcke P, Hauser CH. Cyclosporin requirement during pregnancy in renal transplant recipients. Nephrol Dial Transplant 1989;4:667–9.PubMedGoogle Scholar
  40. 40.
    Piccinni MP, Beloni L, Livi C, Maggi E, Scarselli G, Romasnani S. Defective production of both leukemia inhibitory factor and type 2 T-helper cytokines by decidual T cells in unexplained recurrent abortions. Nat Med 1998;4:1020–4.PubMedCrossRefGoogle Scholar
  41. 41.
    Edwin SS, Branch DW, Scott JR, Silver RM, Dudley DJ, Mitchell MD. Cyclosporin A inhibits prostaglandin E2 production by fetal amnion cells in response to various stimuli. Prostaglandins, 1996;52:51–61.PubMedCrossRefGoogle Scholar
  42. 42.
    Kelly RW. Pregnancy maintenance and parturition: The role of prostaglandins in manipulating the immune and inflammatory response. Endocr Rev 1994;15:684–706.PubMedGoogle Scholar
  43. 43.
    Fowden AL, Harding R, Ralph MM, Thorburn GD. The nutritional regulation of plasma prostaglandin E concentrations in the fetus and pregnant ewe during late gestation. J Physiol 1987;3094:1–12.Google Scholar
  44. 44.
    Thorburn GD. The placenta, prostaglandins and parturition: A review. Reprod Fertil De 1991;3:277–94. CrossRefGoogle Scholar
  45. 45.
    MacGillivray I, Rose GA, Rowe D. Blood pressure survey in pregnancy. Clin Sci 1969;37:395.PubMedGoogle Scholar
  46. 46.
    Sibai BM. Treatment of hypertension in pregnant women. N Engl J Med 1996;335:257–65.PubMedCrossRefGoogle Scholar
  47. 47.
    Churchill D, Perry IJ, Beevers DG. Ambulatory blood pressure in pregnancy and fetal growth Lancet, 1997;349:7–10.Google Scholar
  48. 48.
    Henriksen T. Hypertension in pregnancy: use of antihypertensive drugs. Acta Obstet Gynecol Scand 1997;76:96–106.PubMedCrossRefGoogle Scholar
  49. 49.
    Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy BMJ 1990;301:587–9.Google Scholar
  50. 50.
    Rubin PC, Butters L, Clark DM, Reynolds B, Summer DJ, Steedman D, Low RA, Reid JL. Placebo- controlled trial of atenolol in treatment of pregnancy-associated hypertension. Lancet, 1983;1:431–44.PubMedGoogle Scholar
  51. 51.
    Lip GYH, Beevers M, Churchill D, Shaffer LM, Beevers DG. Effect of atenolol on birthweight Am J Cardiol 1997;15:1436–8.CrossRefGoogle Scholar
  52. Plouin PE, Breart G, Ilado J, Dalle M, Keller ME, Goujon H, Berchel C. A randomised comparison of early with conservative use of antihypertensive drugs in the management of pregnancy- induced hypertension. Brit J Obstet Gynaecol 1990;97:197–204. CrossRefGoogle Scholar
  53. 53.
    Jannet D, Carbonne B, Sebban E, Milliez J. Nicardipine versus metoprolol in the treatment of hypertension during pregnancy. A randomised comparative trial. Obstet Gynecol 1994;84:354–9.Google Scholar
  54. 54.
    Sibai BM, Mabie WC, Shamsa F, Vilar MA, Anderson GD. A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol 1990;162:960–7.PubMedGoogle Scholar
  55. 55.
    Plouin PF, Breart G, Maillard F, Papiernik E, Relier JR Comparison of antihypertensive efficacy and perinatal safety of labetalol and methyldopa in the treatment of hypertensive patients in pregnancy; a randomised controlled trial. Brit J Obstet Gynaecol 1988;95:868–76.CrossRefGoogle Scholar
  56. 56.
    Pickels CF, Syminds EM, Broughton Pipkin F. The fetal outcome in a randomised double blind controlled trial of labetalol versus placebo in pregnancy induced hypertension. Brit J Obstet Gynaecol 1989;96:38–43. CrossRefGoogle Scholar
  57. 57.
    Sibai BA, Gonazalez AR, Mabie WC, Morietti M. A comparison of labetalol plus hospitalisation versus hospitalisation alone in the management of preeclampsia remote from term. Am J Obstet Gynecol 1987;70:323–7.Google Scholar
  58. 58.
    Hanssens M, Keirse MJNC, Vankelecom F, Van Assche FA. Fetal and neonatal effects of treatment with angiotensin-converting enzyme inhibitors in pregnancy. Obstet Gynecol 1991;78:128–35.PubMedGoogle Scholar
  59. 59.
    Montan S, Ingermarsson I, Marsal K, Sjoberg N-O. Randomised controlled trial of atenolol and pindolol in human pregnancy: effects on fetal hemodynamics. BMJ 1992;304:946–9.PubMedCrossRefGoogle Scholar
  60. 60.
    Rasanen J, Jouppila P. Uterine and fetal hemodynamics and fetal cardiac function after atenolol and pindolol infusion - a randomised study. Eur J Obstet Gynecol Reprod Biol 1995;62:195–201.PubMedCrossRefGoogle Scholar
  61. 61.
    Jouppila P, Rasanen J. Effect of labetalol infusion on uterine and fetal hemodynamics and fetal cardiac function. Eur J Obstet Gynecol Reprod Biol 1993;51:111–7.PubMedCrossRefGoogle Scholar
  62. 62.
    Mahmoud TZK, Bjornsson S, Calder AA. Labetalol therapy in pregnancy-induced hypertension - the effects on fetoplacental circulation and fetal-outcome. Eur J Obstet Gynecol Reprod Biol 1993;50:109–13.PubMedCrossRefGoogle Scholar
  63. 63.
    Morgan MA, Silavin SL, Dormer KJ, Fishburne BC, Fishburne JI. Effects of labetalol on uterine blood-flow and cardiovascular hemodynamics in the hypertensive gravid baboon. American J Obstet Gynecol 1993;168:1574–9.Google Scholar
  64. 64.
    Petersen OB, Skajaa K, Svane D, Gregersen H, Forman A. The effects of dihydralazine labetalol and magnesium-sulfate on the isolated, perfused human placental cotyledon. British J Obstet Gynaecol 1994;101:871–8.CrossRefGoogle Scholar
  65. 65.
    Fox H. Placentation in untrauterine growth retardation. Fetal Matern Med Rev 1997;9:61–73.Google Scholar
  66. 66.
    Stewart DE, Streiner DL. Cigarette smoking during pregnancy. Can J Psychiatry 1995;40:603–7.PubMedGoogle Scholar
  67. 67.
    Pritchard CW. Depression and smoking in pregnancy in Scotland. J Epidemiol Community Health 1994;48:377–82.PubMedCrossRefGoogle Scholar
  68. 68.
    Koren G, Shear H, Graham K, Einarson T. Bias against the null hypothesis: The reproductive hazards of cocaine. Lancet 1989;2:1440–2.PubMedCrossRefGoogle Scholar
  69. Kramer MS. Determinants of low birth weight. Methodological assessment and meta-analysis. Bull World Health Organ 1987;65:633–737. Google Scholar
  70. 70.
    Smith R. Beyond conflict of interest. Br M J 1998;317:291–2.CrossRefGoogle Scholar
  71. 71.
    Barnes DE, Bero LA. Why review articles on the health effects of passive smoking reach different conclusions. JAMA 1998;279:1566–70.PubMedCrossRefGoogle Scholar
  72. 72.
    Benowitz NL. Pharmacologic aspects of cigarette smoking and nicotine addiction. N Engl J Med 1988;319:1318–30.PubMedCrossRefGoogle Scholar
  73. 73.
    Russell MAH. The nicotine addiction trap: A 40-year sentence for four cigarettes. Br J Addiction 1990;85:293–300.CrossRefGoogle Scholar
  74. 74.
    Sell L, Finch E, Farrell M, Strang J. Addiction. Br J Hosp Med 1996;56:136–40.PubMedGoogle Scholar
  75. 75.
    Wald NJ, Hackshaw AK. Cigarette smoking: an epidemiological overview. Br Med Bull 1996;52:3–11.PubMedGoogle Scholar
  76. 76.
    Bevan R, Kenney A. Smoking and women’s health. The Diplomate 1996;3:274–9.Google Scholar
  77. 77.
    Kendrick JS, Merritt RK. Women and smoking: an update for the 1990s. Am J Obstet Gynecol 1996;175:528–35.PubMedCrossRefGoogle Scholar
  78. 78.
    Wong PPL, Bauman A. How well does epidemiological evidence hold for the relationship between smoking and adverse obstetric outcomes in New South Wales? Aust N Z J Obstet Gynaecol 1997;37:168–73.PubMedCrossRefGoogle Scholar
  79. 79.
    Ellard GA, Johnstone FD, Prescott RJ, Ji-Xian W, Jian-Hua M. Smoking during pregnancy: the dose dependence of birthweight deficits. Br J Obstet Gynaecol 1996;103:806–13.PubMedCrossRefGoogle Scholar
  80. US Department of Health and Human Services. The health consequences of smoking for women. A report of the Surgeon General. DHHS, 1980.Google Scholar
  81. US Department of Health and Human Services. The health benefits of smoking cessation. A report of the Surgeon General. DHHS, 1990.Google Scholar
  82. 82.
    Rush D, Cassano P. Relationship of cigarette smoking and social class to birthweight and perinatal mortality among all births in Britain, 5–11 April 1970. J Epidemiol Community Health 1983;37:249–55.PubMedCrossRefGoogle Scholar
  83. 83.
    Malloy MH, Kleinman JC, Land GH, Schramm W. The association of maternal smoking with age and cause of infant death. Am J Epidemiol 1988;128:46–55.PubMedGoogle Scholar
  84. 84.
    Ellard GA, Johnstone FD, Prescott RJ, Ji-Xian W, Jian-Hua M. Smoking induced birthweight deficits. Br J Obstet Gynaecol 1996;103:806–13.PubMedCrossRefGoogle Scholar
  85. 85.
    Thompson MJD, Wright SP, Mitchell EA, Clements MS, Becroft DMO, Scragg RKR. Risk factors for small for gestational age infants: a New Zealand study. NZ Med J 1994;107:71–3.Google Scholar
  86. 86.
    Muscati SK, Koski KG, Gray-Donald K. Increased energy intake in pregnant smokers does not prevent human fetal growth retardation. J Nutr 1996;126:2984–9.PubMedGoogle Scholar
  87. 87.
    Withey CH, Papacosta AO, Swan AV, Fitzsimons BA, Ellard GA, Burney PG, et al. Respiratory effects of lowering tar and nicotine levels of cigarettes smoked by young male middle tar smokers: II Results of a randomised controlled trial. J Epidemiol Community Health 1992;46:281–5.PubMedCrossRefGoogle Scholar
  88. 88.
    Haddow JE, Knight GJ, Palomaki GE, Kloza EM, Wald NJ. Cigarette consumption and serum cotinine in relation to birth weight. Br J Obstet Gynaecol 1987;94:678–81.PubMedCrossRefGoogle Scholar
  89. 89.
    Haddow JE, Knight GJ, Palomaki GE, McCarthy JE. Second-trimester serum cotinine levels in nonsmokers in relation to birthweight. Am J Obstet Gynecol 1988;159:481–4.PubMedGoogle Scholar
  90. Martinez FD, Wright AL, Taussig LM, Group Health Medical Associates. The effect of paternal smoking on the birthweight of newborns whose mothers did not smoke. Am J Public Health 1994;84:1489–91PubMedCrossRefGoogle Scholar
  91. 91.
    Lazzaroni F, Bonassi S, Manniello E, Morcaldi L, Repetto E, Ruocco A, et al. Effect of passive smoking during pregnancy on selected perinatal parameters. Int J Epidemiol 1990;19:960–6.PubMedCrossRefGoogle Scholar
  92. Rubin DH, Krasilnikoff PA, Leventhal JM, Weile B, Berget A. Effect of passive smoking on birth-weight. Lancet 1986;ii:415–7.CrossRefGoogle Scholar
  93. 93.
    Ogawa H, Tominaga S, Hori K, Noguchi K, Kanea I, Matsubara M. Passive smoking by pregnant women and fetal growth. J Epidemiol Community Health 1991;45:164–8.PubMedCrossRefGoogle Scholar
  94. 94.
    Lieberman E, Gremy I, Lang JM, Cohen AP. Low birthweight at term and the timing of fetal exposure to maternal smoking. Am J Public Health 1994;84:1127–31.PubMedCrossRefGoogle Scholar
  95. 95.
    Papoz L, Eschwege E, Pequignot G, Barrat J, Schwartz D. Maternal smoking and birth weight in relation to dietary habits. Am J Obstet Gynecol 1982;142:770–86.Google Scholar
  96. 96.
    Naeye RL. Influence of maternal cigarette smoking during pregnancy on fetal and childhood growth. Obstet Gynecol 1981;57:18–21.PubMedGoogle Scholar
  97. 97.
    Benowitz NL. Nicotine replacement therapy during pregnancy. JAMA 1991;266:3174–7.PubMedCrossRefGoogle Scholar
  98. 98.
    Williams LA, Evans SF, Newnham J. Prospective cohort studies of factors influencing the relative weights of the placenta and the newborn infant. BMJ 1997;314:1864–8.PubMedCrossRefGoogle Scholar
  99. 99.
    Pfarrer C, Macara L, Leiser R, Kingdom J. Adaptive angiogenesis in placentas of heavy smokers. Lancet 1999;354:303.PubMedCrossRefGoogle Scholar
  100. 100.
    Jauniaux E, Burton GJ. The effect of smoking in pregnancy on early placental morphology. Obstet Gynecol 1992;79:645–8.PubMedGoogle Scholar
  101. 101.
    van der Veen F, Fox H. The effects of cigarette smoking on the human placenta: a light and electron microscopic study. Placenta 1982;3:243–56.PubMedCrossRefGoogle Scholar
  102. 102.
    Kelly J, Mathews KA, O’Conor M. Smoking in pregnancy: effects on mother and fetus. Br J Obstet Gynaecol 1984;91:111–17.PubMedCrossRefGoogle Scholar
  103. 103.
    Lambers DS, Clark KE. The maternal and fetal physiological effects of nicotine. Semin Perinatol 1996;20:115–26.PubMedCrossRefGoogle Scholar
  104. 104.
    Lehtovirta P, Forss M, Kariniemi V, Rauramo I. Acute effects of smoking on fetal heart rate variability. Br J Obstet Gynaecol 1983;90:3–6.PubMedCrossRefGoogle Scholar
  105. 105.
    Morrow RJ, Ritchie JWK, Bull SB. Maternal cigarette smoking: the effects on umbilical and uterine blood flow velocity. Am J Obstet Gynecol 1988;159:1069–71.PubMedGoogle Scholar
  106. 106.
    Wright LN, Thorp JM, Kuller JA, Shrewsbury RP, Ananth C, Hartmann K. Transdermal nicotine replacement in pregnancy: maternal pharmacokinetics and fetal effects. Am J Obstet Gynecol 1997;176:1090–4.PubMedCrossRefGoogle Scholar
  107. 107.
    Mactutus CF. Developmental neurotoxicity of nicotine, carbon monoxide and other tobacco smoke constituents. Ann NY Acad Sci 1989;562:105–22.PubMedCrossRefGoogle Scholar
  108. 108.
    Longo LD. The biological effects of carbon monoxide on the pregnant woman, fetus and newborn infant. Am J Obstet Gynecol 1977;129:69–103.PubMedGoogle Scholar
  109. 109.
    Longo LD. Carbon monoxide: effects on oxygenation of the fetus in utero. Science 1976;194:523–5.PubMedCrossRefGoogle Scholar
  110. 110.
    Visnjevac V, Mikov M. Smoking and carboxyhaemoglobin concentrations in mothers and their newborn infants. Hum Toxicol 1986;5:175–7.PubMedGoogle Scholar
  111. 111.
    Zaren B, Cnattingius S, Lindmark G. Fetal growth impairment from smoking - is it influenced by maternal anthropometry? Acta Obstet Gynecol Scand 1997;76:30–3.CrossRefGoogle Scholar
  112. 112.
    Jensen OH, Foss OP. Smoking in pregnancy. Effects on the birth weight and on thiocyanate concentrations in mothers and baby. Acta Obstet Gynecol Scand 1981;60:177–81. PubMedGoogle Scholar
  113. 113.
    Wu T, Buck G, Mendola P. Can regular multivitamin/mineral supplementation modify the relation between maternal smoking and select adverse birth outcomes? Ann Epidemiol 1998;8:175–83.PubMedCrossRefGoogle Scholar
  114. 114.
    Kleinman JC, Pierre MB, Madans JH, Land GH, Schramm W. The effects of maternal smoking on fetal and infant mortality. Am J Epidemiol 1988;127:274–82.PubMedGoogle Scholar
  115. 115.
    Meyer MB, Tonascia JA. Maternal smoking, pregnancy complications and perinatal mortality. Am J Obstet Gynecol 1977;128:494–502.PubMedGoogle Scholar
  116. 116.
    Cnattingius S, Haglund B, Meirik O. Cigarette smoking as risk factor for late fetal and early neonatal death. Br M J 1988;297:258–61.CrossRefGoogle Scholar
  117. 117.
    Aim B, Milerad J, Wennergren G, Skaerven R, Oyen N, Norvenius G, et al. A case-control study of smoking and sudden infant death syndrome in the Scandinavian countries, 1992 to 1995. Arch Dis Child 1998;78:329–34.CrossRefGoogle Scholar
  118. 118.
    Mitchell EA, Tuohy PG, Brunt JM, Thompson JMD, Clements MS, Stewart AW, et al. Risk factors for sudden infant death syndrome following the prevention campaign in New Zealand: A prospective study. Pediatrics 1997;100:835–40.PubMedCrossRefGoogle Scholar
  119. 119.
    MacDorman MF, Cnattingius S, Hoffman HJ, Kramer MS, Haglund B. Sudden infant death syndrome and smoking in the United States and Sweden. Am J Epidemiol 1997;146:249–57.PubMedGoogle Scholar
  120. Tager IB, Ngo L, Hanrahan JP. Maternal smoking during pregnancy. Effects on lung function during the first 18 months of life. Am J Respir Crit Care Med 1995;152:977–83. PubMedGoogle Scholar
  121. 121.
    Upton MN, Watt GCM, Smith GD, McConnachie A, Hart CL. Permanent effects of maternal smoking in offspring’s lung function. Lancet 1998;352:453.PubMedCrossRefGoogle Scholar
  122. 122.
    Hu FB, Persky V, Flay BR, Zelli A, Cooksey J, Richardson J. Prevalence of asthma and wheezing in public schoolchildren: Association with maternal smoking during pregnancy. Ann Allergv 1997;79:80–4.CrossRefGoogle Scholar
  123. 123.
    Panjari M, Astbury J, Bishop SM, Dalais, Rice GE. Women who spontaneously quit smoking in early pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology 1997;37:271–8.Google Scholar
  124. 124.
    Ford RPK, Tappin DM, Schlüter PJ, Wild CJ. Smoking during pregnancy: How reliable are maternal self reports in New Zealand? J Epidemiol Community Health 1997;51:246–51.PubMedCrossRefGoogle Scholar
  125. 125.
    Law M, Tang JL. An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med 1995;155:1933–41.PubMedCrossRefGoogle Scholar
  126. 126.
    Sexton M, Hebel JR. A clinical trial of change in maternal smoking and its effect on birth weight JAMA 1984;251:911–5.Google Scholar
  127. 127.
    Lowe JB, Balanda KP, Clare G. Evaluation of antenatal smoking cessation programs for pregnant women. Aust N Z J Public Health 1998;22:55–9.PubMedCrossRefGoogle Scholar
  128. 128.
    Valbo A, Thelle DS, Kolas T. Smoking cessation in pregnancy: A multicomponent intervention study. J Matern Fetal Med 1996;6:3–8.Google Scholar
  129. 129.
    Najman JM, Lanyon A, Andersen MA, Williams G, Bor W, O’Collaghan M. Socioeconomic status and maternal cigarette smoking before, during and after a pregnancy. Aust N Z J Public Health 1998;22:60–6.PubMedCrossRefGoogle Scholar
  130. 130.
    Woolf AD. Smoking and nicotine addiction: A pediatric epidemic with sequelae in adulthood. Curr Opin Pediatr 1997;9:470–7.PubMedCrossRefGoogle Scholar
  131. 131.
    Ebrahim SH, Luman ET, Floyd RL, Murphy CC, Bennett EM, Boyle CA. Alcohol consumption by pregnant women in the United States during 1988–1995. Obstetr Gynecol 1998;92:187–92.CrossRefGoogle Scholar
  132. 132.
    Ashworth M, Gerada C. Addiction and dependence. II alcohol. B M J 1997;315:358–60.Google Scholar
  133. 133.
    Abel EL, Sokol RJ. Fetal alcohol syndrome is now leading cause of mental retardation. Lancet 1986;1:222 [editorial].Google Scholar
  134. 134.
    Oulellette EM, Rosett HL, Rosman NP, Weiner L. Adverse effects in offspring of maternal alcohol abuse during pregnancy. N E J Med 1977;297:528–30.CrossRefGoogle Scholar
  135. 135.
    Abel EL, Hannigan JH. ‘J-shaped’ relationship between drinking during pregnancy and birth weight: Reanalysis of prospective epidemiological data. Alcohol Alcohol 1995;30:345–55.PubMedGoogle Scholar
  136. 136.
    Windham GC, Fenster L, Hopkins B, Swan SH. The association of moderate maternal and paternal alcohol consumption with birthweight and gestational age. Epidemiology 1995;6:591–7.PubMedCrossRefGoogle Scholar
  137. 137.
    Passaro KT, Little RE, Savitz DA, Noss J. The effect of maternal drinking before conception and in early pregnancy on infant birthweight. Epidemiol 1996;7:377–83.CrossRefGoogle Scholar
  138. Lazzaroni, Bonassi S, Magnani M, Calvi A, Repetto E, Serra G, et al. Moderate maternal drinking and outcome of pregnancy. Eur J Epidemiol 1993;9:599–606. PubMedCrossRefGoogle Scholar
  139. 139.
    Larroque B, Kaminski M, Lelong N, Subtil D, Dehaene P. Effects on birth weight of alcohol and caffeine consumption during pregnancy. Am J Epidemiol 1993;137:947–50.Google Scholar
  140. 140.
    Maier SE, Chen W-JA, Miller JA, West JR. Fetal alcohol exposure and temporal vulnerability: Regional differences in alcohol-induced microencephaly as a function of the timing of binge-like alcohol exposure during rat brain development. Alcohol Clin Exp Res 1997;21:1418–28.PubMedGoogle Scholar
  141. 141.
    Maier SE, Chen W-JA, West JR. Prenatal binge-like alcohol exposure alters neurochemical profiles in fetal rat brain. Pharmacol Biochem Behav 1996;55:521–9.PubMedCrossRefGoogle Scholar
  142. 142.
    Goldschmidt L, Richardson GA, Stoffer DS, Geva D, Day NL. Prenatal alcohol exposure and academic achievement at age six: A non-linear fit. Alcohol Clin Exp Res 1996;20:763–70.PubMedCrossRefGoogle Scholar
  143. 143.
    Konovalov HV, Kovetsky NS, Bobryshev YV, Ashwell KWS. Disorders of brain development in the progeny of mothers who used alcohol during pregnancy. Early Hum Dev 1997;48:153–66.PubMedCrossRefGoogle Scholar
  144. 144.
    Zelson C, Lee SJ, Casalino M. Neonatal narcotic addiction: comparative effects of maternal intake of heroin and methadone. N Engl J Med 1973;289:1216–20.PubMedCrossRefGoogle Scholar
  145. 145.
    Connaughton JF, Reeser D, Schut J, Finnegan LP. Prenatal addiction: outcome and management. Am J Obstet Gynecol 1977;129:679–85.PubMedGoogle Scholar
  146. 146.
    Ostrea EM, Chavez CJ. Perinatal problems (excluding neonatal withdrawal) in maternal drug addiction: a study of 830 cases. J Pediatr 1979;94:292–5.PubMedCrossRefGoogle Scholar
  147. 147.
    Ellwood DA, Sutherland P, Kent C, O’Connor M. Maternal narcotic addiction: pregnancy outcome in patients managed by a specialised drug-dependency antenatal clinic. Aust NZJ Obstet Gynaecol 1987;27:92–8.CrossRefGoogle Scholar
  148. 148.
    Alroomi LG, Davidson J, Evans TJ, Galea P, Howat R. Maternal narcotic abuse and the newborn. Arch Dis Child 1988;63:81–3.PubMedCrossRefGoogle Scholar
  149. 149.
    Johnstone FD, Raab GM, Hamilton BA. The effect of human immunodeficiency virus infection and drug use on birth characteristics. Obstet Gynecol 1996;88:321–6.PubMedCrossRefGoogle Scholar
  150. 150.
    Johnstone D. Drug abuse in pregnancy. Contemp Rev Obstet Gynaecol 1990;2:96–103.Google Scholar
  151. 151.
    Taeusch HW, Carson SH, Wang NS, Avery ME. Induction of lung maturation and growth retardation in fetal rabbits. J Pediatr 1972;82:869–75.Google Scholar
  152. 152.
    Crofford M, Smith AA. Growth retardation in young mice treated with methadone. Science 1973;181:947–9.PubMedCrossRefGoogle Scholar
  153. 153.
    Raye JR, Dubin JW, Blechner JN. Fetal growth retardation following maternal morphine administration: nutritional or drug effect. Biol Neonate 1977;32:222.PubMedCrossRefGoogle Scholar
  154. 154.
    Naeye KL, Blanc W, Leblanc W, Khatamee MA. Fetal complications of maternal heroin addiction: abnormal growth, infections, and episodes of stress. J Pediatr 1973;83:1055–61.PubMedCrossRefGoogle Scholar
  155. Tardiff K, Marzuk PM, Leon AC, Portera L, Hartwell N, Hirsch CS, et al. Accidental fatal drug overdoses in New York City: 1990–1992: Am J Drug Alcohol Abuse 1996;22:135–46. PubMedCrossRefGoogle Scholar
  156. 156.
    Marzuk PM, Tardiff K, Leon AC, Hirsch CS, Stajic M, Portera L, et al. Poverty and fatal accidentai drug overdoses of cocaine and opiates in New York City: An ecological study. Am J Drug Alcohol Abuse 1997;23:221–8.PubMedCrossRefGoogle Scholar
  157. 157.
    Woodburn KR, Murie JA. Vascular complications of injecting drug misuse. Br J Surg 1996;83:1329–34.PubMedCrossRefGoogle Scholar
  158. 158.
    Robertson JR, Ronald PJM, Raab GM, Ross AJ, Parpia T. Deaths, HIV infection, abstinence, and other outcomes in a cohort of injecting drug users followed up for 10 years. BMJ 1994;309:369–72.PubMedCrossRefGoogle Scholar
  159. 159.
    Cregler LL, Mark H. Medical complications of cocaine abuse. N Eng J Med 1986;315: 1495–1500.CrossRefGoogle Scholar
  160. 160.
    Marzuk PM, Tardiff K, Leon AC, Hirsch CS, Stajic M, Portera L, et al. Fatal injuries after cocaine use as a leading cause of death among young adults in New York City. N Eng J Med 1995;332:1753–7.CrossRefGoogle Scholar
  161. 161.
    Burkett G, Gomez-Marin O, Yasin S Y, Martinez M. Prenatal care in cocaine-exposed pregnancies. Obstet Gynecol 1998;92:193–200.PubMedCrossRefGoogle Scholar
  162. 162.
    Strauss RS. Effects of the intrauterine environment on childhood growth. Br Med Bull 1997;53:81–95.PubMedGoogle Scholar
  163. 163.
    Miller Jr JM, Boudreaux MC, Regan FA. A case-control study of cocaine use in pregnancy. Am J Obstet Gynecol 1995;172:180–5.PubMedCrossRefGoogle Scholar
  164. 164.
    Shiono PH, Klebanoff MA, Nugent RP, Cotch MF, Wilkins DG, Rollins DE, et al. The impact of cocaine and marijuana use on low birth weight and preterm birth: A multicenter study. Am J Obstet Gynecol 1995;172:19–27.PubMedCrossRefGoogle Scholar
  165. 165.
    Morris P, Binienda Z, Gillam MP, Klein J, McMartin K, Koren G, et al. The effect of chronic cocaine exposure throughout pregnancy on maternal and infant outcomes in the rhesus monkey. Neurotoxicol Teratol 1997;19:47–57.PubMedCrossRefGoogle Scholar
  166. 166.
    Holzman C, Paneth N. Maternal cocaine use during pregnancy and perinatal outcomes. Epidemiol Rev 1994;16:315–34.PubMedGoogle Scholar
  167. 167.
    MacGregor SN, Keith LG, Bachicha JA, Chasnoff IJ. Cocaine abuse during pregnancy: Correlation between prenatal care and perinatal outcome. Obstet Gynecol 1989;74:882–5.PubMedGoogle Scholar
  168. 168.
    Racine A, Joyce T, Anderson R. The association between prenatal care and birthweight among women exposed to cocaine in New York City. JAMA 1993;270:1581–6.PubMedCrossRefGoogle Scholar
  169. 169.
    Broekhuizen FF, Utrie J, Van Mullem C. Drug use or inadequate prenatal care? Adverse pregnancy outcome in an urban setting. Am J Obstet Gynecol 1992;166:1747–56.PubMedGoogle Scholar
  170. English DR, Hulse GK, Milne E, HolmanCDJ, Bower CI. Maternal cannabis use and birth weight: A meta-analysis. Addiction 1997;92:1553–60. PubMedCrossRefGoogle Scholar
  171. 171.
    Jones HE, Kunko PM, Robinson SE, Balster RL. Developmental consequences of intermittent and continuous prenatal exposure to 1,1,1-trichloroethane in mice. Pharmacol Biochem Behav 1996;55:635–46.PubMedCrossRefGoogle Scholar
  172. 172.
    Medrano MA. Does a discrete fetal solvent syndrome exist? Alcohol Treat Quart 1996;14:59–76.CrossRefGoogle Scholar
  173. 173.
    Johnstone FD. Drug addiction and obstetric practice. In: Bewley S, Ward H, editors. Ethics in Obstetrics and Gynaecology. London: RCOG Press, 1994;237–49.Google Scholar
  174. 174.
    Greenwood J. Creating a new drug service in Edinburgh. BMJ 1990;300:587–9.PubMedCrossRefGoogle Scholar
  175. 175.
    Kramer MS. Socioeconomic determinants of intrauterine growth retardation. Eur J Clin Nutr 1998;52:S29–33.PubMedCrossRefGoogle Scholar
  176. 176.
    Carstairs V, Morris R. Deprivation: explaining differences in mortality between Scotland and England and Wales. BMJ 1989;299:886–9.PubMedCrossRefGoogle Scholar
  177. 177.
    Jarman B. Jarman index 1991;302:527.Google Scholar
  178. Wilcox MA, Smith SJ, Johnson IR, Maynard PV, Chilvers CED. The effect of social deprivation on birthweight, excluding physiological and pathological effects. Br J Obstet Gynaecol 1995;102:918–24. PubMedCrossRefGoogle Scholar
  179. Najman JM, Morrison J, Williams GM, Keeping JD, Anderson MJ. Unemployment and reproductive outcome: an Australian study. Br J Obstet Gynaecol 1989;96:308–13. PubMedCrossRefGoogle Scholar
  180. 180.
    Morrison J, Najman JM, Williams GM, Keeping JD, Anderson MJ. Socio-economic status and pregnancy outcome. An Australian study. Br J Obstet Gynaecol 1989;96:298–307.Google Scholar
  181. Hodnett ED. Support from caregivers during at-risk pregnancy - Pregnancy and Childbirth Module: In: Cochrane database of systematic reviews - Review no: 04169. Oxford: Cochrane Updates on Disk - Update Software, 1994;27 April.Google Scholar
  182. 182.
    Gabbe SG, Turner LP. Reproductive hazards of the American lifestyle: Work during pregnancy. Am J Obstet Gynecol 1997;176:826–32.PubMedCrossRefGoogle Scholar
  183. 183.
    Spinillo A, Capuzzo E, Baltaro F, Piazzi G, Nicola S, Iasci A. The effect of work activity in pregnancy on the risk of fetal growth retardation. Acta Obstet Gynecol Scand 1996;75:531–6. Google Scholar
  184. 184.
    Lotgering FK, Gilbert RD, Longo LD. Maternal and fetal responses to exercise during pregnancy. Physiol Rev 1985;65:1–36.PubMedGoogle Scholar
  185. 185.
    Vianna NJ, Polan AK. Incidence of low birth weight among Love Canal residents. Science 1984;226:1217–19.PubMedCrossRefGoogle Scholar
  186. 186.
    Dolk H, Vrijheid M, Armstrong B. Risk of congenital anomalies near hazardous-waste landfill sites in Europe: the EUROHAZCON study. Lancet 1998;352:423–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2000

Authors and Affiliations

  • Frank D. Johnstone
  • David C. Howe

There are no affiliations available

Personalised recommendations