The Effect of Fetal Gender on Maternal Substance Abuse Treatment

Previous studies by this team of investigators has determined that male infants are more
likely to display more severe neonatal abstinence syndrome (NAS) as a result of maternal
opioid use during pregnancy (Jansson, 2007)and there is appears to be a gender-related
biologic vulnerability to NAS expression (Jansson, 2009, submitted). The proposed study
explores the relationship between fetal gender and substance abuse treatment outcomes among
a population of women in comprehensive substance abuse treatment to explore the possibility
of a psychosocial vulnerability among drug exposed male fetuses as opposed to female
fetuses. Women in substance abuse treatment are a group at high risk for current exposure to
violence, usually at the hands of significant others, and having a history of sexual abuse
as a child, usually resulting from contact with a male family member. Therefore, they often
have difficult relationships with men. At the Center for Addiction and Pregnancy (CAP), a
2006 study revealed that among a group of 715 pregnant women, reports of the exposure to
violence was very high. Their rates of lifetime abuse ranged from 72.7% for physical abuse
to 44.5% for sexual abuse. Rates of abuse remained high during their current pregnancy,
ranging from 20% for physical abuse to 7.1% for sexual abuse (Velez, 2006). The abuse was
very often at the hands of partners or other male family member perpetrators. We hypothesize
that women carrying male fetuses will be less likely to remain complaint in drug treatment
or abstinent from illicit drug use, while women carrying female fetuses may be more likely
to remain drug abstinent and treatment compliant. If supported, this theory has the
potential to inform fetal gender specific treatment for pregnant drug dependent women.
Additionally, we seek to support the previously documented link between male gender and more
severe expression of NAS, and explore the relationship between other maternal prescribed
drug use (i.e. psychotropic medications) and severity of NAS expression.