Use of psychoactive substances during pregnancy: Obstetric, neurodevelopmental repercussions and implications in Perinatal Psychiatry
DOI:
https://doi.org/10.33448/rsd-v15i5.51105Keywords:
Pregnancy, Substance-Related Disorders, Substance use Disorders, Prenatal Care, Maternal Health, Neurodevelopment.Abstract
The use of psychoactive substances during pregnancy is highly associated with a significant increase in maternal, fetal, and neonatal morbidity and mortality. In recent decades, there has been an increase in the consumption of legal and illegal substances among women of reproductive age, with relevant repercussions on prenatal care, obstetric outcomes, and child neurodevelopment. The present study aimed to critically review the main maternal, fetal, and neonatal repercussions associated with the use of psychoactive substances during pregnancy, emphasizing contemporary epidemiological, pathophysiological, clinical, and therapeutic aspects. This is a narrative literature review conducted through searches in the PubMed/MEDLINE, SciELO, and Google Scholar databases, including original articles, systematic reviews, meta-analyses, and clinical guidelines preferably published in the last 15 years. The findings demonstrate an association between intrauterine exposure to psychoactive substances and adverse outcomes, including fetal growth restriction, prematurity, premature placental abruption, low birth weight, neonatal withdrawal syndrome, and cognitive, behavioral, and emotional changes in neurodevelopment. A high frequency of psychosocial vulnerability, violence, psychiatric disorders, and inadequate prenatal care was also observed among pregnant women who use substances. It is concluded that the clinical management of these patients requires a multidisciplinary and individualized approach, involving integrated obstetric, psychiatric, neonatal, and psychosocial care. Strategies for early screening, harm reduction, specialized treatment, and strengthening prenatal care are essential for reducing the complications associated with substance use during pregnancy.
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