On September 27, 2018, the Teratology Society hosted a webinar titled "The Challenge of Substance-Exposed Newborns" featuring Dr. Mark Hudak, Chairman and Professor of Pediatrics and Chief of the Division of Neonatology at the University of Florida, College of Medicine – Jacksonville. A recording of this webinar is now available HERE.
This webinar was hosted by the Teratology Society in collaboration with the American College of Toxicology, Developmental Neurotoxicology Society, National Birth Defects Prevention Network, and Organization of Teratology Information Specialists.
Antenatal exposure to certain drugs and substances may have multiple effects on a developing fetus that manifest in the newborn period and beyond. Drugs may act as teratogens; as inhibitors of somatic growth and organ maturation; and as disruptors of central nervous system development. In addition, at or shortly after birth, infants may demonstrate signs of toxicity or withdrawal.
Prenatal exposure to alcohol causes the greatest single drug-induced cumulative preventable intellectual deficit in children. Infants with prenatal exposure to opioids are at risk to develop a constellation of signs of withdrawal known as neonatal abstinence syndrome (NAS) involving primarily the central and autonomic nervous systems and the gastrointestinal system; infants at highest risk at birth are those most recently exposed to long acting opioids with co-exposures due to maternal smoking or use of selective serotonin reuptake inhibitors.
All mothers should be interviewed during prenatal care for the use of drugs and substances so that appropriate treatment can be provided to minimize risks to mother and fetus. The primary treatment of NAS is intensive non-pharmacologic support and monitoring; infants with severe signs of NAS that significantly compromise feeding and growth, sleeping, and socialization respond to pharmacologic therapy. While significant prenatal exposure to alcohol may have devastating long-term effects, the long-term impact of marijuana, opioids, and cocaine on growth, behavior, intelligence, language, and achievement appear to range from no to mild effects and may be modifiable by subsequent environmental exposure and intrinsic resiliency.
Mark Hudak, MD, is Chairman and Professor of Pediatrics and Chief of the Division of Neonatology at the University of Florida, College of Medicine – Jacksonville. Dr. Hudak has many years of experience taking care of babies with neonatal abstinence syndrome and working with their families. His interest in NAS was stimulated when as a member of the American Academy of Pediatrics Committee on Drugs he took on the task of revising the clinical guideline on Neonatal Drug Withdrawal. This 2012 guideline has stimulated improvements in care across the nation. His greatest passion is working to advance the practice of neonatology through engagement in meaningful clinical trials that are well-designed to answer significant clinical questions. Dr. Hudak has served in a number of leadership roles within professional societies as well as serving the public through state and federal appointments. Notably, he currently chairs the Pediatric Advisory Committee of the Food and Drug Administration and the AAP Committee on Child Health Financing. He is also the Chair Elect of the AAP Section on Neonatal Perinatal Medicine.