Long-term Effects of Prenatal Substance
Exposure as the Substance-Exposed
Newborn Ages
Ira J. Chasnoff, MD
[email protected]
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Biological Basis of the Effects
of Prenatal Drug Use:
The Catecholamine System
Catecholamines
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Biological Basis of the Effects
of Prenatal Drug Use:
Methamphetamines
Catecholamines
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Biological Basis of the Effects
of Prenatal Drug Use:
Cocaine
Catecholamines
Cocaine
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Maternal Complications
 Pre-term
labor
 Intrauterine growth retardation
 Placental abruption
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Predictors of Low Birth Weight
Tobacco has a 3x greater impact than
cocaine on predicting low birth
weight.
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Neonatal Complications due to
Exposure to Illicit Drugs
Prematurity
 Low birth weight
 Failure to thrive

NAS
 SIDS
 Dysmorphology

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Neonatal Complications
Low birth weight
 Prematurity
 Failure to thrive

NAS
 SIDS
 Dysmorphology
 CNS damage

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Newborn Neurobehavior
 Motor
skills
 Orientation
 State
regulation
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Biological Basis of the Effects
of Prenatal Drug Use:
The Catecholamine System
Catecholamines
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Biological Basis of the Effects
of Prenatal Drug Use:
Methamphetamine
Catecholamines
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Biological Basis of the Effects
of Prenatal Drug Use:
Cocaine
Catecholamines
Cocaine
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Information Processing
Neurocognitive functioning
Self-regulation
Adaptive functioning
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Behavioral Teratology



The impact of exposure to a foreign agent on
the developing central nervous system and
behavior is a function of multiple factors.
Damage to the CNS during the prenatal period
has effects across the lifespan.
CNS injury may result in behavioral
impairments rather than physical birth
defects.
Vorhees, 1989
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Neurodevelopmental Disorder
Adaptive functioning
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Neurodevelopmental Disorder
Neurocognitive functioning
+Impaired global cognition
Executive functioning deficits
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Neurodevelopmental Disorder
Neurocognitive functioning
Self-regulation
Attention Problems
Impulsivity
Sensory processing
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Treatment
We are not treating prenatal substance
exposure, per se, but the secondary
characteristics that are grounded in
the neurobiological brain changes
induced by prenatal exposure and, in
many cases, early trauma.
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Theoretical Framework for
Treatment
Traumatic brain injury
– Family education/support
– Cognitive therapy
– Executive functioning
Dyadic trauma-informed
– Relational therapy
– Attachment therapy
Self-regulation
– Body awareness
– Sensory processing
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