TY - JOUR
KW - Australia
KW - Canada
KW - Female
KW - Gynecology
KW - Humans
KW - Infant, Newborn
KW - Pregnancy
KW - Prenatal Care
KW - Substance-Related Disorders/epidemiology/therapy
AU - I. Tsakiridis
AU - A. C. Oikonomidou
AU - D. R. Bakaloudi
AU - T. Dagklis
AU - G. Papazisis
AU - M. Chourdakis
A1 - 
AB - IMPORTANCE: Substance use during pregnancy is a major health issue for both the mother and the fetus, but it also represents an important public health concern. OBJECTIVE: The aim of this review was to summarize and compare recommendations from recently published guidelines on substance use during pregnancy and especially regarding alcohol, smoking, and drug use. EVIDENCE ACQUISITION: A descriptive review of guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the World Health Organization (WHO), the Society of Obstetricians and Gynaecologists of Canada, and the American College of Obstetricians and Gynecologists on substance use was conducted. Regarding the term "substance use," the most recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition substances were used. RESULTS: All the reviewed guidelines recommend appropriate counseling and screening women regarding alcohol, smoking, and drug use during the antenatal period, while the management options vary. More specifically, the prompt management of alcohol dependence is emphasized by all the guidelines except from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, which makes no recommendation upon. The use of alcohol during breastfeeding should be avoided. Regarding smoking cessation, all guidelines recommend the use of certain psychosocial, behavioral interventions, and pharmacotherapy. All the guidelines, except the one from the WHO, suggest screening drug users for coexistent sexually transmitted infections. Brief interventions are considered beneficial, while a gradual decrease in benzodiazepines is suggested, as well as the discontinuation of marijuana and methamphetamine use. However, there is controversy regarding breastfeeding in those women as the WHO recommends in favor, whereas the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists recommend against this practice. Finally, all the guidelines state that, following delivery, close monitoring of the neonate is needed. CONCLUSIONS: The diversity of guidelines' recommendations concerning substance use reflects the different ways of the management of pregnant women during routine antenatal care due to absence of strong evidence. More research in the areas of dispute may allow the adoption of an international consensus, in order to early detect and appropriately manage pregnant women with harmful addictions.
AD - Clinical Fellow in Maternal-Fetal Medicine, Third Department of Obstetrics and Gynaecology.; Research Fellow, Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics.; Research Fellow, Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics.; Assistant Professor, Third Department of Obstetrics and Gynaecology.; Associate Professor, Department of Clinical Pharmacology.; Associate Professor, Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
BT - Obstetrical & gynecological survey
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 10
CY - United States
DO - 10.1097/OGX.0000000000000943
IS - 10
JF - Obstetrical & gynecological survey
LA - eng
M1 - Journal Article
N2 - IMPORTANCE: Substance use during pregnancy is a major health issue for both the mother and the fetus, but it also represents an important public health concern. OBJECTIVE: The aim of this review was to summarize and compare recommendations from recently published guidelines on substance use during pregnancy and especially regarding alcohol, smoking, and drug use. EVIDENCE ACQUISITION: A descriptive review of guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the World Health Organization (WHO), the Society of Obstetricians and Gynaecologists of Canada, and the American College of Obstetricians and Gynecologists on substance use was conducted. Regarding the term "substance use," the most recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition substances were used. RESULTS: All the reviewed guidelines recommend appropriate counseling and screening women regarding alcohol, smoking, and drug use during the antenatal period, while the management options vary. More specifically, the prompt management of alcohol dependence is emphasized by all the guidelines except from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, which makes no recommendation upon. The use of alcohol during breastfeeding should be avoided. Regarding smoking cessation, all guidelines recommend the use of certain psychosocial, behavioral interventions, and pharmacotherapy. All the guidelines, except the one from the WHO, suggest screening drug users for coexistent sexually transmitted infections. Brief interventions are considered beneficial, while a gradual decrease in benzodiazepines is suggested, as well as the discontinuation of marijuana and methamphetamine use. However, there is controversy regarding breastfeeding in those women as the WHO recommends in favor, whereas the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists recommend against this practice. Finally, all the guidelines state that, following delivery, close monitoring of the neonate is needed. CONCLUSIONS: The diversity of guidelines' recommendations concerning substance use reflects the different ways of the management of pregnant women during routine antenatal care due to absence of strong evidence. More research in the areas of dispute may allow the adoption of an international consensus, in order to early detect and appropriately manage pregnant women with harmful addictions.
PP - United States
PY - 2021
SN - 1533-9866; 0029-7828
SP - 634
EP - 643
EP - 
T1 - Substance Use During Pregnancy: A Comparative Review of Major Guidelines
T2 - Obstetrical & gynecological survey
TI - Substance Use During Pregnancy: A Comparative Review of Major Guidelines
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 34724075
U3 - 10.1097/OGX.0000000000000943
VL - 76
VO - 1533-9866; 0029-7828
Y1 - 2021
Y2 - Oct
ER -