FIGURE 3-4 Alcohol consumption after finding out about pregnancy: Expectant mothers in the United States, 1988.

SOURCE: Faden, Graubard, and Dufour (1997). Reprinted with permission.

Tobacco Use and Drug Abuse

Alcohol is not alone in its harmful effects on a developing fetus. There is a substantial body of literature to suggest that nicotine has a detrimental impact (Levin and Slotkin, 1998), including increasing the probability of low birthweight (Aronson et al., 1993; Morrison et al., 1993) with the consequences described above. Long-term effects of maternal smoking during pregnancy on later child behavior, controlling for birthweight and other confounding effects, have been found in many studies (Williams et al., 1998; Weitzman et al., 1992; Fergusson et al., 1993), although some have found the effects to be substantial (Williams et al., 1998) and others small (McGee and Stanton, 1994). Mild attentional (Denson et al., 1975; Fried, 1992; Landesman-Dwyer and Emanuel, 1979; Picone et al., 1982a, b; Jacobson et al., 1984) and cognitive effects (Fergusson et al., 1993; Hardy and Mellits, 1972; Lefkowitz, 1981; Naeye and Peters, 1984; Keeping et al., 1989; Butler and Goldstein, 1973; Dunn and McBurney, 1977; Rantakallio, 1983; Gueguen et al., 1995) have been found as well. At 5 and 6 years of age, children exposed to tobacco prenatally had lower receptive language scores and poorer performance on memory tasks (Fried et al., 1992 a, b). Most effects occur at higher exposures (20 or more cigarettes a day) (Williams et al., 1998; Levin and Slotkin, 1998).



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