Rising Substance Use in Pregnancy: More Premature Babies Fighting for Survival in Argentina

The number of pregnant women struggling with substance use is rising, with concerning implications for both maternal and infant health. Increasingly, premature babies are being born to mothers with problematic substance use, placing a significant strain on neonatal intensive care units and highlighting the need for comprehensive support systems.

Experts are observing a growing trend of delayed prenatal care, continued substance use throughout pregnancy, and a lack of adequate support networks, all of which exacerbate the risks. “We have around 1,000 births a year, and We find 200 women who are consumers, whose child is admitted to intensive care or intermediate therapy. We see very high,” explains Gladys Saá, head of the Neonatology Unit at the Fernández Hospital.

Saá, who has worked at Fernández Hospital for 35 years, notes a marked increase in recent years. “We knew that we were having a lot of consumption. A lot of children are born and leave with their mothers, but there are 20 or 30 percent of the patients who enter the service who have some degree of consumption.”

Early Detection and Intervention

The Fernández Hospital employs a coordinated approach with obstetrics, initiating screening during the first prenatal check-ups. If substance use is suspected, women are offered treatment or observation by a toxicology group, with support continuing through and beyond delivery. The goal is to provide opportunities for cessation. “It is known that pregnancy is the most sensitive moment for the mother. For a newborn can stop using,” Saá states.

A recent pilot study conducted at Santa Rosa Hospital in La Pampa, Argentina, objectively assessed psychoactive substance (PS) consumption during pregnancy. The study, involving 51 delivering mothers, utilized standardized interviews and hair sample analysis to detect alcohol, tobacco, licit, illicit, and prescription substance biomarkers. Results indicated that during pregnancy, 49.0% of participants reported alcohol consumption, 25.5% reported tobacco use, and 23.5% reported cannabis use. Hair samples revealed that 56.9% of the women tested positive for illicit PSs, with cocaine being the most frequently detected (41.2%) followed by cannabis (15.7%).

The Argentine study also found that 47.1% of women consumed alcohol during pregnancy, and of those with detectable ethyl glucuronide levels, a significant proportion continued drinking late into gestation. The analysis also identified the presence of prescription substances, caffeine, and adulterants in some samples.

This finding—the prevalence of cocaine use—is notable, as it contrasts with trends observed in neighboring countries. The study underscores the importance of ongoing monitoring of local substance use patterns during pregnancy.

The Impact of Alcohol and Other Substances

Alcohol is particularly damaging during pregnancy, and specialists note a concerning level of social acceptance surrounding its use, contributing to high consumption rates. According to a 2025 fact sheet from the Policy Center for Maternal Mental Health, approximately 5% of pregnant women in the United States use addictive substances. Data from a 2022 survey indicated that 14% of pregnant women reported current alcohol consumption, with about 5% reporting binge drinking.

Alcohol use during pregnancy is linked to Fetal Alcohol Spectrum Disorders (FASDs), a range of conditions that can cause lifelong behavioral, learning, and physical challenges. FASDs are entirely preventable with abstinence during pregnancy.

The Fernández Hospital is seeing a rise in babies born prematurely who require intensive or intermediate care due to low birth weight, respiratory complications, and other conditions. Saá explains that in 2021, approximately 15% of children were born to mothers with a history of substance use; projections for 2025 estimate this number will climb to nearly 30%.

Neonatal Abstinence Syndrome and Long-Term Follow-Up

While neonatal abstinence syndrome (NAS) doesn’t always manifest, it is a potential consequence of prenatal substance exposure. Saá explains that newborns possess some capacity to metabolize certain drugs, and significant maternal consumption is typically required to induce noticeable withdrawal symptoms. Signs of NAS can include irritability, overstimulation, and tachycardia, prompting further testing and potential treatment.

Regardless of whether NAS is present, all babies born to mothers who used substances during pregnancy require long-term follow-up due to the potential for neurodevelopmental alterations. The effects of alcohol exposure, in particular, can be severe and may not become apparent until the child enters school, revealing patterns of high fetal alcohol consumption.

The Fernández Hospital’s ability to provide ongoing follow-up is crucial, as these children are at risk for behavioral disorders, neurological pathologies, and other long-term challenges. Treatment tailored to the specific substance used during pregnancy is essential.

Reaching Vulnerable Populations

Organizations like Alegrate Madre are working to reach pregnant women in vulnerable situations who may not be engaged with the healthcare system. Guillermina Inés Ricciardi, director of Alegrate Madre, emphasizes the importance of proactive outreach. “From 2016 onwards we saw how the number of mothers who were going to give birth directly increased and that set me off with a lot of alerts. How are we arriving so late? Let’s go look for them, knock on their door.”

Ricciardi’s organization provides support and encouragement to women struggling with substance use, emphasizing the importance of believing in their capacity for change. “They use consumption to numb themselves. They always repeat the same thing: ‘They don’t see me, nobody loves me’. Even on the street, when they ask for a piece of bread, many times they don’t give it to them because they are in consumption.”

The underlying message is one of compassion and support, recognizing that motherhood can be a powerful motivator for change. “The pregnant woman wants to stop using if she can think that she can stop using,” Saá emphasizes. “It is an opportunity to be accompanied to stop using.”

Addressing this complex issue requires a multifaceted approach that includes early detection, comprehensive treatment, and sustained support for both mothers and their children. It’s a problem that demands urgent attention from the health system, public policies, and the state, with a focus on providing humane and sustained responses.