• Posted September 7, 2025

Substance Use During Pregnancy Can Harm a Fetus, Experts Warn

Using alcohol, tobacco, marijuana or other substances during pregnancy can harm the developing fetus, even when the risks are not always obvious, a West Virginia University psychiatrist warns.

"Many substances can harm a fetus, including substances many falsely perceive to be harmless, like marijuana," said Dr. Aliana Abascal of the Department of Behavioral Medicine and Psychiatry at WVU School of Medicine.

"Nicotine, not just in the form of cigarettes, but also vaping nicotine, can impact fetal development," she added in a news release. "So can alcohol, methamphetamines and heroin."

Abascal shared the warning ahead of International Fetal Alcohol Spectrum Disorders Awareness Day on Sept. 9.

The U.S. Centers for Disease Control and Prevention (CDC) notes that:

• Nearly 14% of U.S. women report drinking alcohol while pregnant.

• Around 8% report using illicit substances.

• About 7% report using tobacco, though rates are higher in West Virginia at roughly 25%.

Research also shows that U.S. overdose deaths among pregnant and recently pregnant women tripled between 2018 and 2021, Abascal said.

"Substance use during pregnancy can lead to miscarriage or fetal death, birth defects, problems with fetal growth or early delivery, health concerns for the mother, immediate health concerns for the infant after birth," she said.

It also raises the "risk of long-term neurobehavioral conditions like intellectual disability," Abascal said.

She added that babies exposed to alcohol, tobacco or illicit drugs in the womb may experience withdrawal symptoms.

While many substances share overlapping risks, Abascal noted some key differences:

• Nicotine and cocaine can increase the risk of miscarriage and in cocaine’s case, fetal death.

• Alcohol, nicotine, cocaine and opioids can affect the growth of the fetus.

• Alcohol can damage the central nervous system, increasing the risk of fetal alcohol syndrome, a permanent condition.

Abascal said that early medical and behavioral interventions are critical for infants and children who were exposed to substances during pregnancy. 

Pediatric care is essential for evaluating potential health impacts, and some children may require mental health services for developmental or behavioral challenges.

Quitting substances during pregnancy can be difficult, Abascal added, especially when mental health conditions are involved.

"Around 50% of women seeking treatment for substance use disorders also meet criteria for post-traumatic stress disorder, and these women are at high risk of experiencing physical and sexual abuse," she said.

"Treatment may include medications that target the substance use and sometimes contain components of the substance of concern," Abascal added. "For example, nicotine replacement therapy can be used in pregnancy, and while this treatment may impact fetal development, the risks are less than those from smoking cigarettes."

More information

The U.S. Centers for Disease Control and Prevention has more on substance use during pregnancy.

SOURCE: West Virginia University, news release, Sept. 3, 2025