Future substance abuse by crack babies: systematic review

Resumo

Introduction: Household environment with substance abuse influences future drug dependence among younger generations. Hence, children of drug users became the focus of various preventive health and social programs. There is a dearth of evidence on the relation between crack use during pregnancy and future use of crack (and other drugs) by the offspring.

Objective: To assess the effects of crack use during pregnancy on future crack use by the offspring.

Methodology or experience description: Systematic review of studies published up to September 2013 on BVS and CAPES Portals, SciELO, and Science Direct on the effects of crack use by pregnant women on the future crack use by their children. Inclusion criteria: crack use by pregnant women and their children. Exclusion criteria: neonatal abstinence syndrome, crack and congenital malformation, use of other drugs by pregnant women, use of drugs others than crack by children, non-crack-related themes. Two researchers independently selected articles, extracted data, and assessed the methodological quality of all included articles and used consensus to solve disagrements.

Results: We included 10 studies (four qualitative, three cross-sectional, two systematic reviews, and one prospective cohort). All but the systematic reviews were of moderate to high methodological quality, four studies were published in English and six in Portuguese. Many studies interviewed young crack users and their families. Six studies referred to social and family environments; pre and post neonatal exposure to crack use and the moderate to high heritability of drug dependence as influencing factors for crack use by children of women who used crack during pregnancy.

Conclusions or Hypothesis: Children of women who use crack during pregnancy and the immediate post-partum constitute a high risk group for drug abuse, especially crack. Nonetheless, more precise correlation between dosage and time of exposure to crack during pregnancy remains to be established.