การประเมินพัฒนาการและผลกระทบในระยะยาวของทารกที่เกิดจากมารดาที่ตรวจพบการใช้สารแอมเฟตามีนระหว่างการตั้งครรภ์: การศึกษาทิศทางคู่

Abstract

Background: Amphetamine use among pregnant women has increased in the Thai-Lao border area of Loei Province, with rates twice the national average. Amphetamines cross the placental barrier and affect fetal neurological growth and development.

Objective: To evaluate the developmental outcomes and long-term effects in infants born to mothers who tested positive for amphetamine use during pregnancy in the Thai-Lao border area of Loei Province.

Methods: A two-phase bidirectional analytical study was conducted. Phase 1 involved a retrospective review of maternal and infant medical records from public hospitals in Loei Province (2020-2023), comparing 32 mothers who tested positive for amphetamine use with 32 matched controls based on maternal age, gestational age, and socioeconomic status. Phase 2 involved developmental follow-up starting at 12 months of age, with assessments every 6 months using DENVER II and Bayley-III scales. Data were analyzed using t-test, Chi-square test, and multiple logistic regression.

Results: Mothers who used amphetamines during pregnancy had a significantly higher rate of low birth weight infants (<2,500 grams) at 46.9% compared to 21.9% in the control group (OR=3.21, p=0.029). The mean birth weight was 237.1 grams lower (p=0.018). Developmental follow-up at 18.3±6.8 months revealed delayed development in all domains among the study group, particularly in language development (OR=7.22, p=0.007) and emotional-social development. Additionally, 42.9% had a 9-fold higher risk of multi-domain developmental delays (p=0.024). The study group showed significantly more attention deficit problems (OR=5.20, p=0.044) and sleep disturbances (OR=3.45, p=0.040) compared to controls.

Conclusion: Amphetamine use during pregnancy adversely affects birth weight and child development. Enhanced prevention measures, improved screening and monitoring systems for at-risk children, and promotion of breastfeeding are recommended to mitigate these effects in border areas.

Implications: Implement enhanced prevention measures for substance use in pregnant women, develop screening and developmental monitoring systems for at-risk children, promote breastfeeding, and establish multidisciplinary care guidelines specifically for border areas.