Effects of Maternal Methamphetamine Use During Pregnancy and Neonatal Abstinence Syndrome in Sirindhorn Hospital, Khon Kaen Province

Abstract

This study aimed to determine the incidence and risk factors of neonatal withdrawal among infants born to mothers who used methamphetamine during pregnancy. A retrospective cohort study was conducted using medical records of mothers and their neonates delivered at Sirindhorn Hospital, Khon Kaen Province, between January 1, 2022 and December 31, 2024. A total of 51 maternal–neonatal pairs were included. Data were analyzed using descriptive statistics and multiple logistic regression. Neonatal withdrawal was defined as a Neonatal Abstinence Score (NAS) ≥1. The results showed that most mothers were aged 20–34 years (42 cases, 82.4%), and late antenatal care was observed in 46 cases (90.2%). Neonatal withdrawal occurred in 31 infants (60.8%). The most common clinical manifestations included elevated body temperature, jitteriness, and respiratory distress. Multiple logistic regression analysis revealed that neonates with positive urine methamphetamine results had a significantly higher risk of developing withdrawal (Adjusted OR = 5.0; 95% CI = 1.1–22.6; p = 0.035). In addition, neonates presenting with jitteriness were 7.3 times more likely to require admission to the neonatal intensive care unit (Adjusted OR = 7.3; 95% CI = 1.7–31.0; p = 0.001). These findings indicate that maternal methamphetamine use during pregnancy is associated with a high incidence of neonatal withdrawal. Urine drug screening in both mothers and neonates, along with close monitoring of neurological symptoms-particularly jitteriness-are essential for assessing withdrawal severity, guiding clinical management, and determining appropriate referral to higher-level healthcare facilities.