Methamphetamines and Pregnancy Outcomes

Abstract

Introduction Methamphetamine (MA) is one of the most commonly used illicit drugs in pregnancy, yet studies on MA-exposed pregnancy outcomes have been limited because of retrospective measures of drug use, lack of control for confounding factors: other drug use, including tobacco; poverty; poor diet; and lack of prenatal care. This study presents prospective collected data on MA use and birth outcomes, controlling for most confounders. Materials and Methods This is a retrospective cohort study of women obtaining prenatal care from a clinic treating women with substance use disorders, on whom there are prospectively obtained data on MA and other drug use, including tobacco. MA-exposed pregnancies were compared with non-MA exposed pregnancies as well as non-drug exposed pregnancies, using univariate and multivariate analysis to control for confounders. Results One hundred forty-four infants were exposed to MA during pregnancy, 50 had first trimester exposure only, 45 had continuous use until the second trimester, 29 had continuous use until the third trimester, but were negative at delivery and 20 had positive toxicology at delivery. There were 107 non MA-exposed infants and 59 infants with no drug exposure. Mean birth weights were the same for MA-exposed and non-exposed infants (3159 g vs. 3168 g p=0.9), though smaller than those without any drug exposure (3159 vs. 3321 p=0.04), Infants with positive toxicology at birth (meconium or urine) were smaller than infants with first trimester exposure only (2932 g vs. 3300 g p=0.01). Gestation was significantly shorter among the MA-exposed infants compared to non-exposed infants (38.5 vs. 39.1 weeks p=0.045) and those with no drug exposure (38.5 vs. 39.5 p=0.0011), The infants with positive toxicology at birth had a clinically relevant shortening of gestation (37.3 weeks vs. 39.1 p=0.0002). Conclusions MA use during pregnancy is associated with shorter gestational ages and lower birth weight, especially if used continuously during pregnancy. Stopping MA use at any time during pregnancy improves birth outcomes, thus resources should be directed towards providing treatment and prenatal care.

Sex-Specific Alterations of White Matter Developmental Trajectories in Infants With Prenatal Exposure to Methamphetamine and Tobacco

“…Unlike studies 48,49 showing that prenatal methamphetamine exposure is associated with lower birth weight and higher incidence of being small for gestational age, we found no group differences in birth weight, which is consistent with a large study 50 of pregnancy outcomes in methamphetamine-using women. These discrepancies may be attributable to differences in racial or ethnic distributions or participant criteria across studies.…”

Substance Use in the Perinatal Period

“…There are limited data on the prevalence of methamphetamine use in pregnancy, with national estimates varying from 0.7% to 5.2% [137]. Recent work shows that methamphetamine use is associated with shorter gestational ages, lower birthweight [139], fetal loss [140], developmental and behavioral deficits [141], gestational hypertension, preeclampsia, and intrauterine fetal death [142]. Fetal outcomes may vary based on exposure timing and duration[139].…”

“…Recent work shows that methamphetamine use is associated with shorter gestational ages, lower birthweight [139], fetal loss [140], developmental and behavioral deficits [141], gestational hypertension, preeclampsia, and intrauterine fetal death [142]. Fetal outcomes may vary based on exposure timing and duration[139]. Infants with a positive toxicology at delivery were smaller on average compared to infants with methamphetamine exposure during the first trimester only, who were in turn smaller than non-exposed infants [139].…”

“…Fetal outcomes may vary based on exposure timing and duration[139]. Infants with a positive toxicology at delivery were smaller on average compared to infants with methamphetamine exposure during the first trimester only, who were in turn smaller than non-exposed infants [139]. …”

Developmental outcomes following prenatal exposure to methamphetamine: A Western Australian perspective

“…The 2016 National Drug Strategy Household Survey found that 1.3 million Australians had used illicit methamphetamine in their lifetime . Obstetric risks associated with methamphetamine use during pregnancy, including placental abruption, hypertension, preterm birth and fetal growth restriction, are becoming increasingly well defined . The effects of methamphetamine on the developing fetus, however, are less well understood.…”