An increased understanding of maternal health during pregnancy has shed light on the severe impact that substance misuse can have on foetal development. Foetal Alcohol Spectrum Disorder (FASD), and substance misuse-related foetal anomalies (SMFA), are among the most important consequences of substance misuse during pregnancy, with potential life-long physical, cognitive, and behavioural impairments for the affected children. Substance misuse is defined here as ‘recurrent use that is causing actual harms (negative consequences) to the person (including dependence, but also other health, psychological or social problems), or is placing the person at a high probability/risk of suffering such harms’. Alcohol and drug misuse can affect foetal development by invoking placenta defects, respiratory issues, cardiovascular defects, low birth weight (through restricted nourishment caused by drugs and alcohol) and is also linked to sudden infant death syndrome (SIDS). These effects have downstream social and individual consequences throughout the life course.

This Data Insight presents the findings of a study conducted as part of the BOLD Substance Misuse Demonstrator Pilot (Phase 1) in Wales, which focuses on intergenerational substance misuse. Further information on the BOLD programme can be found here: Better Outcomes Through Linked Data (BOLD) This research, focussing on foetal anomalies, forms part of a larger study examining the intergenerational impact of substance misuse on health, social care, education, and criminal justice in order to identify missed opportunities for prevention and promote earlier engagement to reduce substance misuse and related harms.