Pregnant Women Face Health Risks From Psychoactive Substances
Psychoactive substance use during pregnancy exposes mothers to obstetrical and psychiatric complications, while putting fetuses at risk for malformations, growth restriction, and long-term neurocognitive disorders.
Dr. Sarah Coscas, a psychiatrist addictologist and head of the inpatient unit in the addiction department at Paul Brousse Hospital in Villejuif, noted that pregnancy creates a motivational boost that makes it an ideal window for screening and intervention. While many women stop using substances spontaneously when they discover they are pregnant, others maintain minimal use without realizing the risks to their developing child. Practitioners must proactively identify these patients to provide proper education and care.
Alcohol Exposure Threatens Fetal Brain Development
Milder or broader neurodevelopmental effects are known as fetal alcohol spectrum disorders. These cognitive and behavioral issues affect executive functions, attention, and learning, bearing close similarities to attention deficit hyperactivity disorder. French national perinatal surveys tracked a decline in alcohol consumption among pregnant women from 7 percent in 2016 (self-reported) down to 3 percent in 2021 (hetero-reported). Health authorities maintain a zero-alcohol policy from conception onward. Research from South Africa shows that excessive paternal alcohol consumption in the three months preceding pregnancy reduces birth size, head circumference, and verbal IQ in children independently of maternal drinking. Experts advise women to stop drinking at least one month before the start of a pregnancy project, and men to stop three months prior.
Tobacco Remains the Leading Preventable Cause of Complications
Tobacco use during pregnancy persists at roughly 12 percent at the end of pregnancy. It stands as the leading preventable cause of obstetrical complications, including ectopic pregnancies, premature birth, and intrauterine growth restriction.
A 2020 expert report and guideline from the French-speaking Society of Tobaccology and the National College of French Gynecologists and Obstetricians recommends self-help interventions and health education to support smoking cessation. When behavioral measures fail, clinicians can prescribe nicotine replacement therapy at dosages matched to the patient’s habitual use rather than their reduced current intake. The use of electronic cigarettes, with or without nicotine, is discouraged by both societies, though the question of their continuation if they have allowed a woman to stop smoking cigarettes can be considered on a case-by-case basis.
Cannabis Use Exposes Children to Neurological Risks
Cannabis is the most widely consumed illicit substance in the general population, with 1 to 3 percent of pregnant women in France using it. Tetrahydrocannabinol crosses the placenta and interacts with cannabinoid receptors.
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