Prenatal drug exposure is found in thousands of babies each year; rural babies are more likely to have problems

More research is needed on prenatal drug exposure.
(Photo by Jill Sauve, Unsplash)

Amid rural hospitals and clinics ending prenatal care and closing labor and delivery units, unborn children face a quieter threat -- exposure to drugs that limit their in-utero development, can cause lower birth weights and contribute to post-birth disabilities, writes Amna Umer for The Conversation, a journalistic platform for academics. Umer is an associate professor of pediatric epidemiology at West Virginia University. 

Umer writes: "Nearly 1 in 12 newborns in the United States in 2020 – or about 300,000 infants – were exposed to alcohol, opioids, marijuana or cocaine before they were born. . . . These substances can have direct and indirect consequences on fetal development."

When it comes to drug exposure, rural unborn babies are particularly vulnerable. "This includes West Virginia, where I live, a rural Appalachian state struggling with extraordinary rates of substance use and an opioid crisis," Umer explains. "As an epidemiologist, I study the relationship between substance use during pregnancy and infant health outcomes. Our research work showed that between 2020 and 2022, prenatal substance exposure in West Virginia was nearly 50% higher, at 124 per 1,000 births, than the national rate of 80 per 1,000 births."

Poverty and ongoing regional economic stress are part of West Virginia's drug crisis, which extends to pregnant mothers, but there are other factors at play. Umer writes, "Nearly half the population lives in rural areas with limited hospitals and clinics. The geographic isolation limits access to health care and substance use treatment services. Finally, stigma and judgment within close-knit rural communities may discourage these mothers from seeking help."

The body of research on prenatal drug exposure is still growing, and depending on the substance babies were exposed to in the womb, the outcomes vary from low birth weights to withdrawal to developmental delays. Some exposure has a lasting impact on children. Umer explains, "Limited studies have shown an association between neonatal abstinence syndrome and long-term neurodevelopmental consequences that may develop as early as six months old and persist into adolescence. These include delays in learning and language skills, physical growth and motor skills, and difficulty regulating behavior and emotions."