ACCORDING TO A NATIONAL survey on drug use during pregnancy, more than 5 percent of all neonates are exposed to illicit substances in utero.1 Five percent of births may not seem significant, but it represents 221,000 affected neonates each year. Cocaine and marijuana are the most frequently used illicit substances. In addition to illegal substances, we must also be concerned about the use of legal substances that can adversely affect the fetus—specifically, alcohol and tobacco. Annually, about 20 percent of fetuses are exposed to tobacco, which can adversely affect growth and result in an increased risk for low birth weight.1,2 Additionally, approximately 20 percent of neonates are exposed to alcohol, a known teratogen.1,3
