Drugs and alcohol in pregnancy
The World Health Organization is developing guidelines for the identification and management of substance use and substance use disorders in pregnancy. ICM has been invited to contribute to the finalization of these guidelines at a meeting in Geneva.
Consumption of tobacco, alcohol, illicit drugs and other psychoactive substances during pregnancy can lead to multiple health and social problems such spontaneous abortion, stillbirth, low birth weight, prematurity, birth defects, intrauterine growth retardation, neonatal withdrawal symptoms and developmental problems such as fetal alcohol syndrome.
Use of alcohol and other drugs can severely impair an individual's functioning in social roles such as parent, spouse or partner, and instigate and trigger gender-based and domestic violence, thus significantly affecting the development of children. Injecting drug use could also be associated with the increased risk of transmission of HIV-infection and viral hepatitis to fetus and child.
It is crucial for midwives providing antenatal care to identify the use of such substances with pregnant women and be able to assist and guide them. WHO is now in the process of developing guidelines on how to identify and manage substance use and substance use disorders in pregnancy, including tobacco, alcohol and other drugs.
The process began in mid-2012 with the development of the guidelines proposal, a virtual meeting on the Guidelines Development Group (GDG), and subsequent approval of the guidelines proposal by the WHO Guidelines Review Committee. Now the second meeting is held, which brings together members of the GDG, representatives of partner organizations, and observers from interested organizations and institutions. ICM has been invited to take part together with other health care professions associations FIGO and ICN.
The objectives are:
- review the proposed representation of the risks of substance use in pregnancy;
- examine the evidence of clinical trial research on the efficacy of different interventions which identify and manage substance use and reduce the consequences of substance use in pregnancy, as outlined in the GRADE evidence tables;
- examine the non clinical trial evidence of on the benefits and risks of different interventions which identify and manage substance use and reduce the consequences of substance use in pregnancy, as outlined in the GRADE evidence profiles;
- consider the feedback on draft recommendations;
- discuss good examples from around the world which respond to the problems due to substance use in pregnancy;
- develop recommendations on the identification and management of substance use and substance use disorders in pregnancy; and
- discuss and outline the planned guidelines document(s).
This promises to be a very fruitful meeting whose outcome is going to ensure women with special needs are attended to according to their needs. ICM is privileged to have been invited.