Stimulants 

QUICK FACTS

• The most common stimulants are Cocaine, Methamphetamine (Meth), and Amphetamine (ADHD medication known commonly as Adderall)

• Cocaine, Meth, and Amphetamine cross the placenta

• Cocaine causes vasoconstriction (narrowing of blood vessels) which can cause problems associated with poor blood flow1

POSSIBLE RISKS

Cocaine:

• Growth Related Issues2:

  • Small for gestational age (measures small during pregnancy)

  • Reduced birth weight (measures small at birth)

  • Shorter gestational age at delivery (earlier birth than the average)

  • Preterm birth (born before 37 weeks)

• Neurobehavioral effects3,4 (brain and behavior symptoms) may occur within the first 3 days of life. These are likely transient and do not show long term effects. 

  • Tremors/jitteriness

  • High pitched cry

  • Irritability

  • Excessive suck 

  • Vital sign changes (blood pressure, heart rate, respiratory rate)

• Other rare risks may include miscarriage, placental abruption, and small intestinal atresia (poor formation of the small intestine)

Amphetamine and Methamphetamine: 

• Growth related issues5-8: 

  • Fetal growth restriction

  • Preterm birth

  • Reduced birth weight

  • Smaller head circumference 

  • Small for gestational age

• Pregnancy and Birth risks:

  • Preeclampsia

  • Placental abruption

  • Neonatal and Infant death9

• Risk of cognitive problems is unclear. 

WHAT TO LOOK FOR

Cocaine: 

• Look for signs of growth restriction

  • Size

  • Weight

  • Head circumference 

• Look for signs of neurobehavioral problems within the first 3 days of life:

  • Tremors/jitteriness

  • High pitched cry

  • Irritability

  • Excessive suck 

  • Vital sign changes (blood pressure, heart rate, respiratory rate)

• Look for long term cognitive problems:

  • Risk for long term cognitive and behavioral issues is unclear. Some studies show no evidence for cognitive and behavioral issues while some show10,11:

    • Attention deficits

    • Behavioral self regulation (self control) deficits

    • Some minimal language and cognitive delays

    • Minor processing and executive function deficits

Amphetamines: 

• Look for signs of growth restriction

  • Size

  • Weight

  • Head circumference 

• Look for long term cognitive problems:

  • Risk of cognitive problems is unclear. Some studies show no evidence for cognitive problems while others show12,13:

    • Learning and memory difficulty

    • Motor delays (movement/muscle tone)

    • Brain structure changes

    • Attention deficits 

WHAT TO DO 

• Watch for any growth related delays and seek appropriate medical treatment and/or therapy as early as detected. 

• Watch for any behavioral problems as listed above and seek early intervention.

• Talk to your pediatrician about any concerns you may have about your child’s health and development including social and behavioral concerns. 

1. Plessinger MA, Woods JR Jr. Maternal, placental, and fetal pathophysiology of cocaine exposure during pregnancy. Clin Obstet Gynecol. 1993 Jun;36(2):267-78. doi: 10.1097/00003081-199306000-00008. PMID: 8513624.
2. Gouin K, Murphy K, Shah PS; Knowledge Synthesis group on Determinants of Low Birth Weight and Preterm Births. Effects of cocaine use during pregnancy on low birthweight and preterm birth: systematic review and metaanalyses. Am J Obstet Gynecol. 2011 Apr;204(4):340.e1-12. doi: 10.1016/j.ajog.2010.11.013. Epub 2011 Jan 22. PMID: 21257143.
3. Bauer CR, Langer JC, Shankaran S, Bada HS, Lester B, Wright LL, Krause-Steinrauf H, Smeriglio VL, Finnegan LP, Maza PL, Verter J. Acute neonatal effects of cocaine exposure during pregnancy. Arch Pediatr Adolesc Med. 2005 Sep;159(9):824-34. doi: 10.1001/archpedi.159.9.824. PMID: 16143741.
4. Eyler FD, Behnke M, Garvan CW, Woods NS, Wobie K, Conlon M. Newborn evaluations of toxicity and withdrawal related to prenatal cocaine exposure. Neurotoxicol Teratol. 2001 Sep-Oct;23(5):399-411. doi: 10.1016/s0892-0362(01)00166-0. PMID: 11711242.
5. Kalaitzopoulos DR, Chatzistergiou K, Amylidi AL, Kokkinidis DG, Goulis DG. Effect of Methamphetamine Hydrochloride on Pregnancy Outcome: A Systematic Review and Meta-analysis. J Addict Med. 2018 May/Jun;12(3):220-226. doi: 10.1097/ADM.0000000000000391. PMID: 29509557.
6. Nguyen D, Smith LM, Lagasse LL, Derauf C, Grant P, Shah R, Arria A, Huestis MA, Haning W, Strauss A, Della Grotta S, Liu J, Lester BM. Intrauterine growth of infants exposed to prenatal methamphetamine: results from the infant development, environment, and lifestyle study. J Pediatr. 2010 Aug;157(2):337-9. doi: 10.1016/j.jpeds.2010.04.024. Epub 2010 Jun 8. PMID: 20570284; PMCID: PMC3018351.
7. Arria AM, Derauf C, Lagasse LL, Grant P, Shah R, Smith L, Haning W, Huestis M, Strauss A, Della Grotta S, Liu J, Lester B. Methamphetamine and other substance use during pregnancy: preliminary estimates from the Infant Development, Environment, and Lifestyle (IDEAL) study. Matern Child Health J. 2006 May;10(3):293-302. doi: 10.1007/s10995-005-0052-0. Epub 2006 Jan 5. PMID: 16395620.
8. Smith LM, LaGasse LL, Derauf C, Grant P, Shah R, Arria A, Huestis M, Haning W, Strauss A, Della Grotta S, Liu J, Lester BM. The infant development, environment, and lifestyle study: effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth. Pediatrics. 2006 Sep;118(3):1149-56. doi: 10.1542/peds.2005-2564. PMID: 16951010.
9. Gorman MC, Orme KS, Nguyen NT, Kent EJ 3rd, Caughey AB. Outcomes in pregnancies complicated by methamphetamine use. Am J Obstet Gynecol. 2014 Oct;211(4):429.e1-7. doi: 10.1016/j.ajog.2014.06.005. Epub 2014 Jun 4. PMID: 24905417.
10. Conradt E, Sheinkopf SJ, Lester BM, Tronick E, LaGasse LL, Shankaran S, Bada H, Bauer CR, Whitaker TM, Hammond JA; Maternal Lifestyle Study. Prenatal substance exposure: neurobiologic organization at 1 month. J Pediatr. 2013 Oct;163(4):989-94.e1. doi: 10.1016/j.jpeds.2013.04.033. Epub 2013 Jun 4. PMID: 23743094; PMCID: PMC3773295.
11. Lambert BL, Bauer CR. Developmental and behavioral consequences of prenatal cocaine exposure: a review. J Perinatol. 2012 Nov;32(11):819-28. doi: 10.1038/jp.2012.90. Epub 2012 Jul 12. PMID: 22791278; PMCID: PMC4143247.
12. LaGasse LL, Derauf C, Smith LM, Newman E, Shah R, Neal C, Arria A, Huestis MA, DellaGrotta S, Lin H, Dansereau LM, Lester BM. Prenatal methamphetamine exposure and childhood behavior problems at 3 and 5 years of age. Pediatrics. 2012 Apr;129(4):681-8. doi: 10.1542/peds.2011-2209. Epub 2012 Mar 19. PMID: 22430455; PMCID: PMC3313637.
13. Kwiatkowski MA, Donald KA, Stein DJ, Ipser J, Thomas KGF, Roos A. Cognitive outcomes in prenatal methamphetamine exposed children aged six to seven years. Compr Psychiatry. 2018 Jan;80:24-33. doi: 10.1016/j.comppsych.2017.08.003. Epub 2017 Aug 24. PMID: 28950153.