Individual effects of alcohol, smoking and drug use on UPM score. Full cohort was separated into five groups: control (no exposure, C, N = 17), smoking (S, N = 13), drug use (D, N = 10), alcohol (A, N = 15), alcohol with smoking (A + S, N = 42) and alcohol with drug use (A + D, N = 10). H&E sections of placentas were scored for the presence of placental hypoplasia (placental weight <10th %ile for the gestational age) and eight histologic findings that have been associated with maternal vascular malperfusion (**P < 0.01, ****P < 0.0001).