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Tennessee Group raising Awareness of Legal Substances that can cause Serious Harm to Babies in the Womb

Harmful Effects to Baby May Include Lower I.Q. for Life

Tennessee Department of Health - TDOHNashville, TN – An occasional glass of wine. A cigarette. A pain pill, prescribed by a doctor. All three are perfectly legal, yet each may cause harm to an unborn baby. Effects can range from short- to long-term, from behavioral and learning issues to a withdrawal syndrome the baby endures right after birth, to physical defects. Some or all of these can have an adverse impact over the baby’s entire life.

A group of health, medical and government professionals from Tennessee is combining strengths to help more women of child-bearing years understand the potential dangers of alcohol, nicotine and prescription medicines.

Two major challenges, according to Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, are helping more people understand that just because a substance is legal doesn’t make it safe for pregnant women to use, and that some legally-obtained substances can do just as much, or even more, harm than illegal ones.

“Women who must take medications to treat health conditions during pregnancy should have a conversation with their healthcare providers about balancing risks and benefits of all drugs and discussing which are safest,” Dreyzehner said. “Stopping a treatment suddenly may be riskier than continuing to use a medication under a physician’s care; it varies from situation to situation. Some things like alcohol and nicotine should simply not be used and in all cases a potential mother, family and baby are better off if the pregnancy is intentional and the circumstances have been considered beforehand.”

Stephen Patrick, MD, MPH, is a neonatologist and assistant professor of pediatrics and health policy at Vanderbilt University. Working with hundreds of infants every year, he’s seen firsthand how nicotine can cause low birth weights, the effects of fetal alcohol syndrome, and how prescribed pain medicines can cause an infant to have drug withdrawal after birth, known as neonatal abstinence syndrome or NAS.

“Infants exposed to cigarettes, alcohol and prescription opioids in utero are at increased risk of having complications,” Patrick said. “Among their greatest risk is being born premature and low birth weight, both of which increase their risk for life-long problems. Importantly, alcohol use in pregnancy is the single largest preventable cause of developmental delay among children. We need to do a better job in reducing the number of babies born each year whose health is jeopardized by legal, readily available substances.”

While Tennessee started a controlled substance monitoring database in 2012 to help address misuse of powerful prescription drugs, Dreyzehner and Patrick said many more people now understand the need for more unified efforts to help pregnant women avoid alcohol, nicotine and other substances. In January, work began on establishing a statewide consortium of health, medical, science, government and community leaders to heighten awareness and reduce the health damages from legal substances.

Small group meetings began in February and additional organizations and individuals have since joined the effort. Participating organizations thus far include seven departments and divisions of state government including Health, Mental Health and Substance Abuse Services, Human Services, Children’s Services, Safety and Homeland Security, the Division of Health Care Finance and Administration and the Children’s Cabinet, along with a mix of public and private-sector stakeholders.

“Addressing misconceptions is a priority for the group,” said Tennessee Department of Mental Health and Substance Abuse Services Commissioner E. Douglas Varney. “For example, some pregnant women still think it is okay to use tobacco or drink alcohol early in a pregnancy. It’s not. Others may mistakenly believe electronic cigarettes may be safer than regular cigarettes. In fact, because there is no government regulation of the amount of nicotine these devices contain, a woman could ingest harmful amounts of nicotine or other chemicals when she thinks she is using a safer alternative. Our recommendation is simple: if you’re pregnant, don’t drink alcohol, use tobacco products or any vapor-emitting devices.”

Beyond the small group meetings, TDH staff members are conducting chronic pain guidelines seminars across the state for medical students and practicing clinicians.

Learn more about TDH services and programs at www.tn.gov/health.


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