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. 1991 Sep;37:1953–1962.

Teratogenic Effects of `Recreational' Drugs

Increasing the risk of congenital anomalies

Janine E Polifka, JM Friedman
PMCID: PMC2145913  PMID: 21229112

Abstract

Published data from clinical studies for commonly abused substances were identified through a TOXLINE bibliographic search. References in teratology monographs and review articles were also used. Emphasis was placed on controlled epidemiological studies. Available evidence suggests that maternal alcohol or cocaine abuse substantially increases the risk of congenital anomalies among infants. Many recreational drugs cause neurobehavioral dysfunction in neonates exposed before birth.

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Selected References

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  1. Abel E. L. Smoking during pregnancy: a review of effects on growth and development of offspring. Hum Biol. 1980 Dec;52(4):593–625. [PubMed] [Google Scholar]
  2. Alroomi L. G., Davidson J., Evans T. J., Galea P., Howat R. Maternal narcotic abuse and the newborn. Arch Dis Child. 1988 Jan;63(1):81–83. doi: 10.1136/adc.63.1.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Aselton P., Jick H., Milunsky A., Hunter J. R., Stergachis A. First-trimester drug use and congenital disorders. Obstet Gynecol. 1985 Apr;65(4):451–455. [PubMed] [Google Scholar]
  4. Beattie J. O. Transplacental alcohol intoxication. Alcohol Alcohol. 1986;21(2):163–166. [PubMed] [Google Scholar]
  5. Bertollini R., Källen B., Mastroiacovo P., Robert E. Anticonvulsant drugs in monotherapy. Effect on the fetus. Eur J Epidemiol. 1987 Jun;3(2):164–171. doi: 10.1007/BF00239754. [DOI] [PubMed] [Google Scholar]
  6. Bingol N., Fuchs M., Diaz V., Stone R. K., Gromisch D. S. Teratogenicity of cocaine in humans. J Pediatr. 1987 Jan;110(1):93–96. doi: 10.1016/s0022-3476(87)80297-4. [DOI] [PubMed] [Google Scholar]
  7. Bracken M. B. Drug use in pregnancy and congenital heart disease in offspring. N Engl J Med. 1986 Apr 24;314(17):1120–1120. doi: 10.1056/NEJM198604243141717. [DOI] [PubMed] [Google Scholar]
  8. Bracken M. B., Holford T. R. Exposure to prescribed drugs in pregnancy and association with congenital malformations. Obstet Gynecol. 1981 Sep;58(3):336–344. [PubMed] [Google Scholar]
  9. Buck C. Letter: Drugs in pregnancy. Can Med Assoc J. 1975 Jun 7;112(11):1285–1285. [PMC free article] [PubMed] [Google Scholar]
  10. Burkett G., Yasin S., Palow D. Perinatal implications of cocaine exposure. J Reprod Med. 1990 Jan;35(1):35–42. [PubMed] [Google Scholar]
  11. Busacca M., Gementi P., Gambini E., Lenti C., Meschi F., Vignali M. Neonatal effects of the administration of meperidine and promethazine to the mother in labor. Double blind study. J Perinat Med. 1982;10(1):48–53. doi: 10.1515/jpme.1982.10.1.48. [DOI] [PubMed] [Google Scholar]
  12. Chasnoff I. J., Burns K. A., Burns W. J., Schnoll S. H. Prenatal drug exposure: effects on neonatal and infant growth and development. Neurobehav Toxicol Teratol. 1986 Jul-Aug;8(4):357–362. [PubMed] [Google Scholar]
  13. Chasnoff I. J., Burns W. J., Hatcher R. P., Burns K. A. Phencyclidine: effects on the fetus and neonate. Dev Pharmacol Ther. 1983;6(6):404–408. doi: 10.1159/000457343. [DOI] [PubMed] [Google Scholar]
  14. Chasnoff I. J., Bussey M. E., Savich R., Stack C. M. Perinatal cerebral infarction and maternal cocaine use. J Pediatr. 1986 Mar;108(3):456–459. doi: 10.1016/s0022-3476(86)80896-4. [DOI] [PubMed] [Google Scholar]
  15. Chasnoff I. J., Chisum G. M., Kaplan W. E. Maternal cocaine use and genitourinary tract malformations. Teratology. 1988 Mar;37(3):201–204. doi: 10.1002/tera.1420370304. [DOI] [PubMed] [Google Scholar]
  16. Chasnoff I. J., Griffith D. R., MacGregor S., Dirkes K., Burns K. A. Temporal patterns of cocaine use in pregnancy. Perinatal outcome. JAMA. 1989 Mar 24;261(12):1741–1744. [PubMed] [Google Scholar]
  17. Chasnoff I. J., Hatcher R., Burns W. J., Schnoll S. H. Pentazocine and tripelennamine ('T's and blue's'): effects on the fetus and neonate. Dev Pharmacol Ther. 1983;6(3):162–169. doi: 10.1159/000457291. [DOI] [PubMed] [Google Scholar]
  18. Cherukuri R., Minkoff H., Feldman J., Parekh A., Glass L. A cohort study of alkaloidal cocaine ("crack") in pregnancy. Obstet Gynecol. 1988 Aug;72(2):147–151. [PubMed] [Google Scholar]
  19. Chávez G. F., Mulinare J., Cordero J. F. Maternal cocaine use during early pregnancy as a risk factor for congenital urogenital anomalies. JAMA. 1989 Aug 11;262(6):795–798. doi: 10.1001/jama.1989.03430060091031. [DOI] [PubMed] [Google Scholar]
  20. Cohen M. M., Shiloh Y. Genetic toxicology of lysergic acid diethylamide (LSD-25). Mutat Res. 1977;47(3-4):183–209. doi: 10.1016/0165-1110(77)90003-3. [DOI] [PubMed] [Google Scholar]
  21. Coles C. D., Smith I. E., Fernhoff P. M., Falek A. Neonatal ethanol withdrawal: characteristics in clinically normal, nondysmorphic neonates. J Pediatr. 1984 Sep;105(3):445–451. doi: 10.1016/s0022-3476(84)80027-x. [DOI] [PubMed] [Google Scholar]
  22. Crombie D. L., Pinsent R. J., Fleming D. M., Rumeau-Rouquette C., Goujard J., Huel G. Letter: Fetal effects of tranquilizers in pregnancy. N Engl J Med. 1975 Jul 24;293(4):198–199. doi: 10.1056/nejm197507242930415. [DOI] [PubMed] [Google Scholar]
  23. Czeizel A. Lack of evidence of teratogenicity of benzodiazepine drugs in Hungary. Reprod Toxicol. 1987 1988;1(3):183–188. doi: 10.1016/s0890-6238(87)80031-x. [DOI] [PubMed] [Google Scholar]
  24. Dattel B. J. Substance abuse in pregnancy. Semin Perinatol. 1990 Apr;14(2):179–187. [PubMed] [Google Scholar]
  25. Desmond M. M., Schwanecke R. P., Wilson G. S., Yasunaga S., Burgdorff I. Maternal barbiturate utilization and neonatal withdrawal symptomatology. J Pediatr. 1972 Feb;80(2):190–197. doi: 10.1016/s0022-3476(72)80577-8. [DOI] [PubMed] [Google Scholar]
  26. Dunn D. W., Reynolds J. Neonatal withdrawal symptoms associated with 'T's and blues' (pentazocine and tripelennamine). Am J Dis Child. 1982 Jul;136(7):644–645. doi: 10.1001/archpedi.1982.03970430076024. [DOI] [PubMed] [Google Scholar]
  27. Ente G., Mehra M. C. Neonatal withdrawal from propoxyphene hydrochloride. N Y State J Med. 1978 Nov;78(13):2084–2085. [PubMed] [Google Scholar]
  28. Farrar H. C., Kearns G. L. Cocaine: clinical pharmacology and toxicology. J Pediatr. 1989 Nov;115(5 Pt 1):665–675. doi: 10.1016/s0022-3476(89)80640-7. [DOI] [PubMed] [Google Scholar]
  29. Finnegan L. P. Effects of maternal opiate abuse on the newborn. Fed Proc. 1985 Apr;44(7):2314–2317. [PubMed] [Google Scholar]
  30. Fricker H. S., Segal S. Narcotic addiction, pregnancy, and the newborn. Am J Dis Child. 1978 Apr;132(4):360–366. doi: 10.1001/archpedi.1978.02120290032004. [DOI] [PubMed] [Google Scholar]
  31. Fried P. A. Marihuana use by pregnant women and effects on offspring: an update. Neurobehav Toxicol Teratol. 1982 Jul-Aug;4(4):451–454. [PubMed] [Google Scholar]
  32. Fried P. A., O'Connell C. M. A comparison of the effects of prenatal exposure to tobacco, alcohol, cannabis and caffeine on birth size and subsequent growth. Neurotoxicol Teratol. 1987 Mar-Apr;9(2):79–85. doi: 10.1016/0892-0362(87)90082-1. [DOI] [PubMed] [Google Scholar]
  33. Garey R. E., Daul G. C., Samuels M. S., Ragan F. A., Hite S. A. PCP abuse in New Orleans: a six-year study. Am J Drug Alcohol Abuse. 1987;13(1-2):135–144. doi: 10.3109/00952998709001504. [DOI] [PubMed] [Google Scholar]
  34. Giannini A. J., Loiselle R. H., Giannini M. C. Space-based abstinence: alleviation of withdrawal symptoms in combinative cocaine-phencyclidine abuse. J Toxicol Clin Toxicol. 1987;25(6):493–500. doi: 10.3109/15563658708992652. [DOI] [PubMed] [Google Scholar]
  35. Gillberg C. "Floppy infant syndrome" and maternal diazepam. Lancet. 1977 Jul 30;2(8031):244–244. doi: 10.1016/s0140-6736(77)92855-0. [DOI] [PubMed] [Google Scholar]
  36. Golden N. L., Kuhnert B. R., Sokol R. J., Martier S., Williams T. Neonatal manifestations of maternal phencyclidine exposure. J Perinat Med. 1987;15(2):185–191. doi: 10.1515/jpme.1987.15.2.185. [DOI] [PubMed] [Google Scholar]
  37. Graham J. M., Jr, Hanson J. W., Darby B. L., Barr H. M., Streissguth A. P. Independent dysmorphology evaluations at birth and 4 years of age for children exposed to varying amounts of alcohol in utero. Pediatrics. 1988 Jun;81(6):772–778. [PubMed] [Google Scholar]
  38. Hadeed A. J., Siegel S. R. Maternal cocaine use during pregnancy: effect on the newborn infant. Pediatrics. 1989 Aug;84(2):205–210. [PubMed] [Google Scholar]
  39. Hanson J. W., Streissguth A. P., Smith D. W. The effects of moderate alcohol consumption during pregnancy on fetal growth and morphogenesis. J Pediatr. 1978 Mar;92(3):457–460. doi: 10.1016/s0022-3476(78)80449-1. [DOI] [PubMed] [Google Scholar]
  40. Hatch E. E., Bracken M. B. Effect of marijuana use in pregnancy on fetal growth. Am J Epidemiol. 1986 Dec;124(6):986–993. doi: 10.1093/oxfordjournals.aje.a114488. [DOI] [PubMed] [Google Scholar]
  41. Hingson R., Alpert J. J., Day N., Dooling E., Kayne H., Morelock S., Oppenheimer E., Zuckerman B. Effects of maternal drinking and marijuana use on fetal growth and development. Pediatrics. 1982 Oct;70(4):539–546. [PubMed] [Google Scholar]
  42. Hodgkinson R., Bhatt M., Wang C. N. Double-blind comparison of the neurobehaviour of neonates following the administration of different doses of meperidine to the mother. Can Anaesth Soc J. 1978 Sep;25(5):405–411. doi: 10.1007/BF03006570. [DOI] [PubMed] [Google Scholar]
  43. Hoegerman G., Wilson C. A., Thurmond E., Schnoll S. H. Drug-exposed neonates. West J Med. 1990 May;152(5):559–564. [PMC free article] [PubMed] [Google Scholar]
  44. Hoyme H. E., Jones K. L., Dixon S. D., Jewett T., Hanson J. W., Robinson L. K., Msall M. E., Allanson J. E. Prenatal cocaine exposure and fetal vascular disruption. Pediatrics. 1990 May;85(5):743–747. [PubMed] [Google Scholar]
  45. Jacobs I. G., Roszler M. H., Kelly J. K., Klein M. A., Kling G. A. Cocaine abuse: neurovascular complications. Radiology. 1989 Jan;170(1 Pt 1):223–227. doi: 10.1148/radiology.170.1.2909100. [DOI] [PubMed] [Google Scholar]
  46. Jacobson C. B., Berlin C. M. Possible reproductive detriment in LSD users. JAMA. 1972 Dec 11;222(11):1367–1373. [PubMed] [Google Scholar]
  47. Jick H., Holmes L. B., Hunter J. R., Madsen S., Stergachis A. First-trimester drug use and congenital disorders. JAMA. 1981 Jul 24;246(4):343–346. [PubMed] [Google Scholar]
  48. Johanson C. E., Fischman M. W. The pharmacology of cocaine related to its abuse. Pharmacol Rev. 1989 Mar;41(1):3–52. [PubMed] [Google Scholar]
  49. Johnston C. Cigarette smoking and the outcome of human pregnancies: a status report on the consequences. Clin Toxicol. 1981 Feb;18(2):189–209. doi: 10.3109/15563658108990026. [DOI] [PubMed] [Google Scholar]
  50. Kandall S. R., Albin S., Gartner L. M., Lee K. S., Eidelman A., Lowinson J. The narcotic-dependent mother: fetal and neonatal consequences. Early Hum Dev. 1977 Oct;1(2):159–169. doi: 10.1016/0378-3782(77)90017-2. [DOI] [PubMed] [Google Scholar]
  51. Kelly T. E. Teratogenicity of anticonvulsant drugs. I: Review of the literature. Am J Med Genet. 1984 Nov;19(3):413–434. doi: 10.1002/ajmg.1320190302. [DOI] [PubMed] [Google Scholar]
  52. Koch S., Göpfert-Geyer I., Häuser I., Hartmann A., Jakob S., Jäger-Roman E., Nau H., Rating D., Helge H. Neonatal behaviour disturbances in infants of epileptic women treated during pregnancy. Prog Clin Biol Res. 1985;163B:453–461. [PubMed] [Google Scholar]
  53. Koren G., Graham K., Shear H., Einarson T. Bias against the null hypothesis: the reproductive hazards of cocaine. Lancet. 1989 Dec 16;2(8677):1440–1442. doi: 10.1016/s0140-6736(89)92044-8. [DOI] [PubMed] [Google Scholar]
  54. Laegreid L., Olegård R., Walström J., Conradi N. Teratogenic effects of benzodiazepine use during pregnancy. J Pediatr. 1989 Jan;114(1):126–131. doi: 10.1016/s0022-3476(89)80619-5. [DOI] [PubMed] [Google Scholar]
  55. Leonard B. E. Behavioural teratology: post-natal consequences of drug exposure in utero. Arch Toxicol Suppl. 1982;5:48–58. doi: 10.1007/978-3-642-68511-8_7. [DOI] [PubMed] [Google Scholar]
  56. Levin J. N. Amphetamine ingestion with biliary atresia. J Pediatr. 1971 Jul;79(1):130–131. doi: 10.1016/s0022-3476(71)80075-6. [DOI] [PubMed] [Google Scholar]
  57. Lifschitz M. H., Wilson G. S., Smith E. O., Desmond M. M. Factors affecting head growth and intellectual function in children of drug addicts. Pediatrics. 1985 Feb;75(2):269–274. [PubMed] [Google Scholar]
  58. Lifschitz M. H., Wilson G. S., Smith E. O., Desmond M. M. Fetal and postnatal growth of children born to narcotic-dependent women. J Pediatr. 1983 May;102(5):686–691. doi: 10.1016/s0022-3476(83)80234-0. [DOI] [PubMed] [Google Scholar]
  59. Linn S., Schoenbaum S. C., Monson R. R., Rosner R., Stubblefield P. C., Ryan K. J. The association of marijuana use with outcome of pregnancy. Am J Public Health. 1983 Oct;73(10):1161–1164. doi: 10.2105/ajph.73.10.1161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Little B. B., Snell L. M., Gilstrap L. C., 3rd Methamphetamine abuse during pregnancy: outcome and fetal effects. Obstet Gynecol. 1988 Oct;72(4):541–544. [PubMed] [Google Scholar]
  61. Little B. B., Snell L. M., Gilstrap L. D., 3rd, Johnston W. L. Patterns of multiple substance abuse during pregnancy: implications for mother and fetus. South Med J. 1990 May;83(5):507-9, 518. doi: 10.1097/00007611-199005000-00008. [DOI] [PubMed] [Google Scholar]
  62. Little B. B., Snell L. M., Klein V. R., Gilstrap L. C., 3rd Cocaine abuse during pregnancy: maternal and fetal implications. Obstet Gynecol. 1989 Feb;73(2):157–160. [PubMed] [Google Scholar]
  63. Long S. Y. Does LSD induce chromosomal damage and malformations? A review of the literature. Teratology. 1972 Aug;6(1):75–90. doi: 10.1002/tera.1420060110. [DOI] [PubMed] [Google Scholar]
  64. MacGregor S. N., Keith L. G., Chasnoff I. J., Rosner M. A., Chisum G. M., Shaw P., Minogue J. P. Cocaine use during pregnancy: adverse perinatal outcome. Am J Obstet Gynecol. 1987 Sep;157(3):686–690. doi: 10.1016/s0002-9378(87)80029-7. [DOI] [PubMed] [Google Scholar]
  65. Milkovich L., van der Berg B. J. Effects of antenatal exposure to anorectic drugs. Am J Obstet Gynecol. 1977 Nov 15;129(6):637–642. doi: 10.1016/0002-9378(77)90645-7. [DOI] [PubMed] [Google Scholar]
  66. Mirmiran M., Swaab D. F. Influence of drugs on brain neurotransmitters and behavioral states during development. Dev Pharmacol Ther. 1987;10(5):377–384. doi: 10.1159/000457767. [DOI] [PubMed] [Google Scholar]
  67. Morrison J. C., Wiser W. L., Rosser S. I., Gayden J. O., Bucovaz E. T., Whybrew W. D., Fish S. A. Metabolites of meperidine related to fetal depression. Am J Obstet Gynecol. 1973 Apr 15;115(8):1132–1137. doi: 10.1016/0002-9378(73)90564-4. [DOI] [PubMed] [Google Scholar]
  68. Naeye R. L., Blanc W., Leblanc W., Khatamee M. A. Fetal complications of maternal heroin addiction: abnormal growth, infections, and episodes of stress. J Pediatr. 1973 Dec;83(6):1055–1061. doi: 10.1016/s0022-3476(73)80550-5. [DOI] [PubMed] [Google Scholar]
  69. Nakane Y., Okuma T., Takahashi R., Sato Y., Wada T., Sato T., Fukushima Y., Kumashiro H., Ono T., Takahashi T. Multi-institutional study on the teratogenicity and fetal toxicity of antiepileptic drugs: a report of a collaborative study group in Japan. Epilepsia. 1980 Dec;21(6):663–680. doi: 10.1111/j.1528-1157.1980.tb04320.x. [DOI] [PubMed] [Google Scholar]
  70. Nelson M. M., Forfar J. O. Associations between drugs administered during pregnancy and congenital abnormalities of the fetus. Br Med J. 1971 Mar 6;1(5748):523–527. doi: 10.1136/bmj.1.5748.523. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Nora J. J., Vargo T. A., Nora A. H., Love K. E., McNamara D. G. Dexamphetamine: a possible environmental trigger in cardiovascular malformations. Lancet. 1970 Jun 13;1(7659):1290–1291. doi: 10.1016/s0140-6736(70)91765-4. [DOI] [PubMed] [Google Scholar]
  72. O'Connell C. M., Fried P. A. An investigation of prenatal cannabis exposure and minor physical anomalies in a low risk population. Neurobehav Toxicol Teratol. 1984 Sep-Oct;6(5):345–350. [PubMed] [Google Scholar]
  73. O'Connor M. C. Drugs of abuse in pregnancy--an overview. Med J Aust. 1987 Aug 17;147(4):180–183. doi: 10.5694/j.1326-5377.1987.tb133352.x. [DOI] [PubMed] [Google Scholar]
  74. Oleske J. M. Experiences with 118 infants born to narcotic-using mothers. Does a lowered serum-ionized calcium level contribute to the symptoms of withdrawal? Clin Pediatr (Phila) 1977 May;16(5):418–423. doi: 10.1177/000992287701600502. [DOI] [PubMed] [Google Scholar]
  75. Ostrea E. M., Chavez C. J. Perinatal problems (excluding neonatal withdrawal) in maternal drug addiction: a study of 830 cases. J Pediatr. 1979 Feb;94(2):292–295. doi: 10.1016/s0022-3476(79)80847-1. [DOI] [PubMed] [Google Scholar]
  76. Qazi Q. H., Mariano E., Milman D. H., Beller E., Crombleholme W. Abnormalities in offspring associated with prenatal marihuana exposure. Dev Pharmacol Ther. 1985;8(2):141–148. doi: 10.1159/000457031. [DOI] [PubMed] [Google Scholar]
  77. Quillian W. W., 2nd, Dunn C. A. Neonatal drug withdrawal from propoxyphene. JAMA. 1976 May 10;235(19):2128–2128. [PubMed] [Google Scholar]
  78. Rementería J. L., Bhatt K. Withdrawal symptoms in neonates from intrauterine exposure to diazepam. J Pediatr. 1977 Jan;90(1):123–126. doi: 10.1016/s0022-3476(77)80785-3. [DOI] [PubMed] [Google Scholar]
  79. Renfroe C. L., Messinger T. A. Street drug analysis: an eleven year perspective on illicit drug alteration. Semin Adolesc Med. 1985 Dec;1(4):247–257. [PubMed] [Google Scholar]
  80. Robert E., Löfkvist E., Mauguière F., Robert J. M. Evaluation of drug therapy and teratogenic risk in a Rhône-Alpes district population of pregnant epileptic women. Eur Neurol. 1986;25(6):436–443. doi: 10.1159/000116048. [DOI] [PubMed] [Google Scholar]
  81. Rosenberg L., Mitchell A. A., Parsells J. L., Pashayan H., Louik C., Shapiro S. Lack of relation of oral clefts to diazepam use during pregnancy. N Engl J Med. 1983 Nov 24;309(21):1282–1285. doi: 10.1056/NEJM198311243092103. [DOI] [PubMed] [Google Scholar]
  82. Rothman K. J., Fyler D. C., Goldblatt A., Kreidberg M. B. Exogenous hormones and other drug exposures of children with congenital heart disease. Am J Epidemiol. 1979 Apr;109(4):433–439. doi: 10.1093/oxfordjournals.aje.a112701. [DOI] [PubMed] [Google Scholar]
  83. Rothstein P., Gould J. B. Born with a habit. Infants of drug-addicted mothers. Pediatr Clin North Am. 1974 May;21(2):307–321. [PubMed] [Google Scholar]
  84. Safra M. J., Oakley G. P., Jr Association between cleft lip with or without cleft palate and prenatal exposure to diazepam. Lancet. 1975 Sep 13;2(7933):478–480. doi: 10.1016/s0140-6736(75)90548-6. [DOI] [PubMed] [Google Scholar]
  85. Saxén I. Associations between oral clefts and drugs taken during pregnancy. Int J Epidemiol. 1975 Mar;4(1):37–44. doi: 10.1093/ije/4.1.37. [DOI] [PubMed] [Google Scholar]
  86. Saxén I. Epidemiology of cleft lip and palate. An attempt to rule out chance correlations. Br J Prev Soc Med. 1975 Jun;29(2):103–110. [PMC free article] [PubMed] [Google Scholar]
  87. Shapiro S., Hartz S. C., Siskind V., Mitchell A. A., Slone D., Rosenberg L., Monson R. R., Heinonen O. P. Anticonvulsants and parental epilepsy in the development of birth defects. Lancet. 1976 Feb 7;1(7954):272–275. doi: 10.1016/s0140-6736(76)91403-3. [DOI] [PubMed] [Google Scholar]
  88. Shiono P. H., Mills J. L. Oral clefts and diazepam use during pregnancy. N Engl J Med. 1984 Oct 4;311(14):919–920. doi: 10.1056/NEJM198410043111413. [DOI] [PubMed] [Google Scholar]
  89. Sims M. E., Walther F. J. Neonatal ultrasound casebook. Antenatal brain injury and maternal cocaine use. J Perinatol. 1989 Sep;9(3):349–350. [PubMed] [Google Scholar]
  90. Speight A. N. Floppy-infant syndrome and maternal diazepam and/or nitrazepam. Lancet. 1977 Oct 22;2(8043):878–878. doi: 10.1016/s0140-6736(77)90817-0. [DOI] [PubMed] [Google Scholar]
  91. Stillman R. J., Rosenberg M. J., Sachs B. P. Smoking and reproduction. Fertil Steril. 1986 Oct;46(4):545–566. doi: 10.1016/s0015-0282(16)49628-7. [DOI] [PubMed] [Google Scholar]
  92. Stimmel B., Adamsons K. Narcotic dependency in pregnancy. Methadone maintenance compared to use of street drugs. JAMA. 1976 Mar 15;235(11):1121–1124. doi: 10.1001/jama.235.11.1121. [DOI] [PubMed] [Google Scholar]
  93. Stone M. L., Salerno L. J., Green M., Zelson C. Narcotic addiction in pregnancy. Am J Obstet Gynecol. 1971 Mar 1;109(5):716–723. doi: 10.1016/0002-9378(71)90757-5. [DOI] [PubMed] [Google Scholar]
  94. Strauss A. A., Modaniou H. D., Bosu S. K. Neonatal manifestations of maternal phencyclidine (PCP) abuse. Pediatrics. 1981 Oct;68(4):550–552. [PubMed] [Google Scholar]
  95. Streissguth A. P., Clarren S. K., Jones K. L. Natural history of the fetal alcohol syndrome: a 10-year follow-up of eleven patients. Lancet. 1985 Jul 13;2(8446):85–91. doi: 10.1016/s0140-6736(85)90189-8. [DOI] [PubMed] [Google Scholar]
  96. Streissguth A. P., Sampson P. D., Barr H. M. Neurobehavioral dose-response effects of prenatal alcohol exposure in humans from infancy to adulthood. Ann N Y Acad Sci. 1989;562:145–158. doi: 10.1111/j.1749-6632.1989.tb21013.x. [DOI] [PubMed] [Google Scholar]
  97. Tennes K., Avitable N., Blackard C., Boyles C., Hassoun B., Holmes L., Kreye M. Marijuana: prenatal and postnatal exposure in the human. NIDA Res Monogr. 1985;59:48–60. [PubMed] [Google Scholar]
  98. Zierler S., Rothman K. J. Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy. N Engl J Med. 1985 Aug 8;313(6):347–352. doi: 10.1056/NEJM198508083130603. [DOI] [PubMed] [Google Scholar]
  99. Zuckerman B., Frank D. A., Hingson R., Amaro H., Levenson S. M., Kayne H., Parker S., Vinci R., Aboagye K., Fried L. E. Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med. 1989 Mar 23;320(12):762–768. doi: 10.1056/NEJM198903233201203. [DOI] [PubMed] [Google Scholar]
  100. von Almen W. F., 2nd, Miller J. M., Jr "Ts and Blues" in pregnancy. J Reprod Med. 1986 Apr;31(4):236–239. [PubMed] [Google Scholar]

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