For the Health Professional:

Potential Nutrition-Related Effects of Tobacco, Alcohol, and Illegal Drugs

  • Impaired fetal growth. Many mechanisms may be involved.

  • Low maternal food intake. This may be related to decreased appetite (e.g., cocaine and amphetamines are appetite suppressants), substitution of the substance (e.g., alcohol) for food, lack of money to spend on food, or any combination of these.

  • Increased nutrient requirements, for example:

    • Cigarette smoking increases the metabolism and thus the need for vitamin C.

    • Alcohol impairs the absorption or utilization of several nutrients and may impair the placental transport of certain nutrients.

  • Concern about body size. Some women who quit smoking or who quit using other harmful substances may become anxious about gaining too much weight.

Weight-for-Height Status

Obesity increases the risk of developing many chronic diseases and complications of pregnancy. Low weight-for-height increases the risk of delivering a low birth weight baby.

Laboratory Evaluation

A positive screen for anemia (hemoglobin <12.0 g/dl, nonsmokers), elevated blood lipids, or other abnormal conditions call for additional testing or intervention.

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