The effects of alcohol and other drugs on the developing fetus can be devastating both in terms of fetal development and the potential for postpartum complications. The National Institute on Drug Abuse has estimated that during gestation nearly 20% of infants were exposed to alcohol, 17% were exposed to marijuana, nearly 5% were exposed to cocaine, and nearly 40% were exposed to tobacco. The rates of exposure to opi-oids and amphetamines are less well known, but according to A. Nobel and colleagues perinatal exposure studies conducted in California suggest exposure in the 1 % to 2% range. It should be noted, however, that when neonatologists and other specialists selectively screen infants who are considered high risk, rates of exposure are dramatically higher (e.g., perinatal rates ...

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