Narcotic addiction in pregnancy

It is estimated that there are 25,000 female addicts in the Metropolitan area of New York City. As a consequence, we are faced with a significant number of pregnant addicts. Our study of over 300 such patients demonstrates the problems they present. Over 90 per cent of these women had no or inadequate prenatal care. The incidence of maternal complications has been markedly higher than in our general clinic population. Obstetric complications include prematurity, toxemia, breech births, and precipitate labor. As might be expected, prostitution serves as the source of income to support the drug habit, and the incidence of venereal disease and hepatitis is increased. Over 70 per cent of the neonates show congenital neonatal addiction with clinically recognizable withdrawal symptoms. These symptoms suggest hyperactivity of the autonomic nervous system as evidenced by diaphoresis, diarrhea, and rhinorrhea. Hypertonicity and a characteristic high-pitched shrill cry are frequently observed. In addition to being premature by dates, 50 per cent of these infants show evidence of retarded intrauterine growth. The severity of the symptoms seems to be maternal dose related.