Prenatal Methamphetamine Exposure and Neonatal Outcomes

Abstract

Objective: To study the neonatal outcomes of maternal methamphetamine abuse during pregnancy, which included prematurity, low birth weight, jaundice, hypoglycemia, respiratory depression and feeding intolerance. The factors affecting neonatal drug withdrawal symptoms were also studied.
Study design: Retrospective case-control study.
Methods: The medical records of the 80 infants who had the maternal history of methamphetamine abuse, had positive urine methamphetamine and was delivered at Faculty of medicine Vajira hospital during 1 July 2011 - 1 July 2014 were reviewed.
Results: Eighty infants were enrolled, 56.2% were male, 81.3% had normal delivery, 28.8% were preterm infants, 13.8% had neonatal jaundice, 5% had hypoglycemia and 8.8% had feeding problem. Most had 1 minutes APGAR scores of 9 (73.8%), 90% of infants did not needed neonatal resuscitation, 4 infants need oxygen flow and 4 infants need positive pressure ventilation. All of them had normal head circumference, birth weight and length. There were 31 infants (38.7%) with drug withdrawal symptoms. All of them had NAS scores less than 8 points and 23.8% of drug withdrawal infants had NAS scores ≥4 (moderate group). The moderate group had significantly more maternal no antenatal cares (OR 0.27), more female infants (OR 0.48), lower birth weight, longer duration of positive neonatal urine methamphetamine, longer duration of hospital stay and less maternal use of others substance abuse (OR 4) than the mild group (NAS scores <4). Multivariate analysis identified factors found to be associated with moderate withdrawal symptoms were female infants (p-value <0.001, β = 0.63; 95%CI 0.56-0.85) and duration of positive neonatal urine methamphetamine (p-value <0.001, β = 0.97; 95%CI 0.28-0.52).
Conclusion: Approximately one-third of maternal methamphetamine abuse had preterm labors and one-third of infants had drug withdrawal symptoms. Factors associated with moderate withdrawal symptoms were female infants and the duration of positive neonatal urine methamphetamine.