Pregnant Women Who Avoid Drug Abuse Reduce Their Risk of Stillbirth

Every year, 3.6 million women are blessed with new babies. But more than 8 million women struggle with fertility issues and another 21,000 lose their babies to stillbirths.

A stillbirth is the loss of a baby after the 20th week of pregnancy. While there are several causes of stillbirth including the age of the mother or her high blood pressure, a preventable cause of stillbirth is drug abuse. There are multiple drugs that can affect a mother’s ability to give birth to a live baby. Even the use of some of these drugs before pregnancy starts can increase the risk of stillbirth.

Compiling Statistics on Stillbirths and Drug Use

In the past, self-reporting was used to determine if women’s drug use could have contributed to their stillbirths. This is, of course, not an accurate way to determine this statistic because many women do not want to admit to drug use while pregnant. In 2013, a study was done using drug testing of umbilical cords to determine how many stillborn babies were exposed to drugs. This study found that smoking tobacco (even second-hand exposure) or using marijuana, illicit stimulants, or painkillers increased the risk of stillbirth, sometimes doubling it.

How Each Drug Increases the Risk of Stillbirth

Cocaine: As a stimulant, cocaine increases heart rate and blood pressure, leading to serious problems in pregnancy. The outcome can be miscarriage, premature delivery, or stillbirth due to placental abruption—the separation of the placenta from the uterus. Babies that survive are also more likely to be smaller and have low birth weight and more emotional and cognitive problems.

Cocaine also slows down the baby’s growth, especially after 32 weeks of gestation. This decreased fetal growth may be a contributing factor to stillbirth. Those who use cocaine are four times more likely to also use tobacco. Cocaine together with nicotine can work synergistically to increase the risk of a poor pregnancy outcome.

Methamphetamine: The use of methamphetamine is associated with placental abruption, a significant cause of stillbirth. This is in addition to an increased possibility of the baby having heart and brain abnormalities, as well as cognitive and behavioral issues as they grow up and begin school.

Methamphetamine exerts stimulant effects not only on the central nervous system but also on the cardiovascular system of the mother. This means that the baby’s blood pressure will also increase. In animal studies, this increase of fetal blood pressure led to a shortage of oxygen for the fetus. A lack of sufficient oxygen is one of the causes of stillbirth.

Marijuana: The use of marijuana early in pregnancy is associated with poor outcomes of pregnancy. During the early weeks, the placenta is forming. Like other drugs, marijuana affects the ability of the placenta to provide a baby with oxygen and nutrients, which increases the risk of stillbirth. Other adverse effects include poor fetal growth and a higher risk of maternal high blood pressure.

The issue of increased risk of stillbirth due to early-pregnancy cannabis use is particularly important as many women may use this drug to alleviate morning sickness. A 2018 research project sought to determine how many marijuana dispensaries or retail stores would recommend the use of cannabis to pregnant women as a solution for morning sickness. Sixty-nine percent of businesses contacted recommended first-trimester use of cannabis products for this problem. Among medical marijuana dispensaries, 83% recommended marijuana use. Only 32% of the staff making these recommendations pointed out that the caller should also discuss this recommendation with a licensed healthcare provider.

Painkillers: A relationship has been found between first- and second-trimester exposure to opioid painkillers (codeine, morphine, and oxycodone) and stillbirth. An association was even found between low doses of opioid painkillers and stillbirth.

Opioid painkillers can slow the mother’s breathing, which can reduce the amount of oxygen that reaches the baby. In severe cases, this can cause stillbirth. Chronic opioid use during pregnancy is associated with fetal growth restriction, which causes an eightfold increase in the risk of stillbirth.

When a pregnant woman abuses opioid painkillers, she increases her risk of placental abruption, stillbirth, and other complications of pregnancy.

Alcohol: The relationship between alcohol and poor birth and fetal outcomes has long been known. Stillbirth is one of the poor outcomes that can result from drinking during pregnancy. A 2002 study showed that drinking more than five alcoholic drinks per week led to a threefold increase in stillbirth risk. That study was followed with one in 2008 that found that any alcohol consumption at all increased the likelihood of stillbirth by 40% compared to those who did not drink any alcohol. It is possible that alcohol interferes with the function or size of the placenta, or it could impair the flow of blood and nutrients to the fetus.

Drug-Related Stillbirths: Preventable Tragedies

Stillbirths resulting from drug or alcohol abuse are 100% preventable. To prevent these losses, women who are pregnant or who are of childbearing age need the help of family and friends if they are using drugs or alcohol. In this situation, if and when pregnancy occurs, the life saved is not only the woman’s—it is also the baby’s.

Babies that are spared the effects of alcohol or drugs not only have a chance of making it full-term but they also have a greater chance of being physically and mentally as healthy as possible. This gives each child their best chance for lifelong success. That is a worthy goal.

Sources:

• “Births and Natality.” Centers for Disease Control and Prevention, 2024. CDC

• “Data and Statistics on Stillbirth.” Centers for Disease Control and Prevention, 2024. CDC

• “Tobacco, Drug Use in Pregnancy Can Double Risk of Stillbirth.” National Institutes of Health, 2013. NIH

• “Substance Use While Pregnant and Breastfeeding.” National Institute on Drug Abuse, 2015. NIDA

• “Investigating Mechanisms of Stillbirth in the Setting of Prenatal Substance Use.” National Library of Medicine, 2018. NLM

• “What Are the Risks of Methamphetamine Misuse During Pregnancy?” National Institute on Drug Abuse, 2011. NIDA

• “Low Fetal Resistance to Hypoxia as a Cause of Stillbirth and Neonatal Encephalopathy.” IMRPress, 2024. IMRPress

• “New Research Finds that People Who Use Cannabis Early in Pregnancy Are At Increased Risk of Poor Pregnancy Outcomes.” Society for Maternal-Fetal Medicine, 2023. SMFM

• “Recommendations From Cannabis Dispensaries About First-Trimester Cannabis Use.” National Library of Medicine, 2018. NLM
  
• “Prenatal Opioid Analgesics and the Risk of Adverse Birth Outcomes.” National Library of Medicine, 2021. NLM

• “Maternal and Fetal Risk Factors for Stillbirth: Population Based Study.” British Medical Journal, 2013. BMJ

• “Opioid Abuse and Dependence during Pregnancy. Temporal Trends and Obstetrical Outcomes.” American Society of Anesthesiologists, 2014. ASA

• “Prenatal Alcohol Exposure and Miscarriage, Stillbirth, Preterm Delivery, and Sudden Infant Death Syndrome.” National Library of Medicine, 2011. NLM