Mental and Behavioral Disorders Due to Substance Abuse and Perinatal Outcomes: A Study Based on Linked Population Data in New South Wales, Australia

Abstract

Background: The effects of mental and behavioral disorders (MBD) due to substance use during peri-conception and pregnancy on perinatal outcomes are unclear. The adverse perinatal outcomes of primiparous mothers admitted to hospital with MBD due to substance use before and/or during pregnancy were investigated. Method: This study linked birth and hospital records in NSW, Australia. Subjects included primiparous mothers admitted to hospital for MBD due to use of alcohol, opioids or cannabinoids during peri-conception and pregnancy. Results: There were 304 primiparous mothers admitted to hospital for MBD due to alcohol use (MBDA), 306 for MBD due to opioids use (MBDO) and 497 for MBD due to cannabinoids (MBDC) between the 12 months peri-conception and the end of pregnancy. Primiparous mothers admitted to hospital for MBDA during pregnancy or during both peri-conception and pregnancy were significantly more likely to give birth to a baby of low birthweight (AOR = 4.03, 95%CI: 1.97–8.24 for pregnancy; AOR = 9.21, 95%CI: 3.76–22.57 both periods); preterm birth (AOR = 3.26, 95% CI: 1.52–6.97 for pregnancy; AOR = 4.06, 95%CI: 1.50–11.01 both periods) and admission to SCN or NICU (AOR = 2.42, 95%CI: 1.31–4.49 for pregnancy; AOR = 4.03, 95%CI: 1.72–9.44 both periods). Primiparous mothers admitted to hospital for MBDO, MBDC or a combined diagnosis were almost three times as likely to give birth to preterm babies compared to mothers without hospital admissions for psychiatric or substance use disorders. Babies whose mothers were admitted to hospital with MBDO before and/or during pregnancy were six times more likely to be admitted to SCN or NICU (AOR = 6.29, 95%CI: 4.62–8.57). Conclusion: Consumption of alcohol, opioids or cannabinoids during peri-conception or pregnancy significantly increased the risk of adverse perinatal outcomes.

Short‐term health outcomes of newborn infants of substance‐using mothers in Australia and New Zealand: A systematic review

“…Preterm birth refers to birth that occurs less than 37 weeks of gestation . Sixteen studies mentioned an association between substances use during pregnancy and preterm birth . The association was found significant with most of the drugs included in the studies (Table ).…”

“…This refers to neonate weight of less than 2500 g at birth . Nine studies reported that the exposure of newborn infants to single or polysubstance use in pregnancy increased the possibility of low birthweight (Table ) . The use of cannabis, opiate or heavy alcohol consumption was significantly associated with low birthweight .…”

“…Signficant associations between maternal substance use and admission of neonates to either neonatal intensive care unit or special nurseries were reported in eight studies . Opioid‐exposed babies were six times; cannabinoids or polysubstance exposed babies were two and four times more likely to have been admitted to these facilities, respectively .…”

“…Signficant associations between maternal substance use and admission of neonates to either neonatal intensive care unit or special nurseries were reported in eight studies . Opioid‐exposed babies were six times; cannabinoids or polysubstance exposed babies were two and four times more likely to have been admitted to these facilities, respectively . Two studies reported the median length of stay in the neonatal intensive care unit and or special care nursery for the neonates of opioids‐, stimulants‐ and cannabis‐using mothers – 8 days for opioids, 5 days for stimulants and 3 days for cannabis …”

“…Pooled OR was computed for two outcomes, namely preterm birth and small‐for‐gestational age. The association between alcohol and or other drug use during pregnancy and preterm birth was mentioned in five studies, totaling 160 247 participants. All five studies were of acceptable quality.…”