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Methamphetamine Use during Pregnancy Dramatically Increases Risk to Baby

Methamphetamine abuse has become the most common reason for women to seek drug counseling or treatment while pregnant. A recent study by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that not only had treatment facilities across the U.S. seen the highest number of pregnant teenage admissions in a decade, but the largest shift in the type of substance abuse being treated was caused by methamphetamine use. Pregnant teenage admissions for methamphetamine abuse had more than quadrupled from 4.3% of admissions in 1992 to 18.8% in 2007. Despite the higher percentage of pregnant meth abusers in rehabilitation, an even greater number of female meth abusers do not seek treatment. Unfortunately, some maintain their habit even after becoming pregnant.

A new study led by Dr. Ido Solt at Los Angeles’ Cedars-Sinai Medical Center found that not only had methamphetamine use among pregnant women rose in recent years, but the babies born to these mothers face serious health complications compared to babies born to non-methamphetamine-using mothers.

Solt and colleagues assessed the prevalence of methamphetamine use among pregnant women admitted to a single Phoenix hospital from 2000 to 2006. The researchers identified 276 cases of methamphetamine use among pregnant hospital admissions and 34,055 non-methamphetamine-related pregnancies. Methamphetamine use was determined either by patient’s verbal admission to methamphetamine use or by urine screenings that tested positive for methamphetamine. Researchers noticed a gradual incline in the number of pregnant methamphetamine users throughout the years of the study: first there were 22 cases in 2001, then 43 cases in 2004, then 77 cases in 2005.

Researchers compared health characteristics between the 276 methamphetamine-related pregnancies and the 34,055 control pregnancies to determine the frequency of certain health risks among newborns and their mothers. On almost every health measure surveyed in their study, researchers found that babies born to methamphetamine abusers were at higher risk.

Methamphetamine-abusing mothers showed the common characteristic of uncontrolled high blood pressure during their pregnancy—a serious risk that causes severe, life-threatening stress to the fetus. Almost 20% of pregnant methamphetamine users had uncontrolled blood pressure, and another 10% had experienced placental abruption—two exceptionally rare complications during pregnancy that affect less than 1% of the general population. More than half of methamphetamine-abusing mothers had delivered premature births, while only 17% of the control pregnancies were preterm.

Twenty-nine percent of methamphetamine-using mothers had cesarean births, whereas the control group only experienced cesarean deliveries 23% of the time. Babies born the methamphetamine abusers had low scores on a newborn health test 6% of the time, but only 1% of births from the control group had low health scores. Babies of methamphetamine-using mothers were more likely to undergo neonatal mortality compared to the control group; 4% of methamphetamine-related births died shortly after birth whereas only 1% of births from the control group experienced neonatal deaths.

Mothers who used methamphetamine during their pregnancies showed remarkable differences compared to mothers from the control group. More than two-thirds of methamphetamine-abusing mothers reported having fewer than five prenatal appointments during their pregnancy, compared to 10% of mothers from the control group. Methamphetamine-using women were more likely to experience domestic violence compared to the control group. Almost one-fourth of methamphetamine-using mothers reported domestic violence.

Furthermore, just 12% of methamphetamine-using mothers were married, but 46% of the control group’s mothers were married. The majority of methamphetamine-using mothers was older, white, English-speaking, unemployed, and abused other substances. After successful delivery, 40% of methamphetamine-using mothers lost custody of their babies who were then placed in foster care, Child Protective Services, adoption, or were receiving care from another individual.

The predominance of these demographics, the researchers claim, can help doctors identify methamphetamine use among pregnant women and help circumvent morbid maternal and neonatal outcomes. Sometimes the physical characteristics of methamphetamine abuse—such as "meth mouth," low weight, and skin sores—can indicate a methamphetamine-abusing patient to a health physician. However, especially in the face of higher methamphetamine use among women, some patients do not exhibit these noticeable features.

Toxicity screening can help determine the presence of methamphetamine in a mother, but only if she has used the substance within the past 36 hours. It is vital that doctors detect substance abuse in expecting mothers early on since the neonatal effects of methamphetamine use are dangerous, irreversible, and permanent. By evaluating these common characteristics among pregnant women, doctors may be able to identify methamphetamine abuse more easily, and can implement intervention and prevention strategies earlier during the pregnancy.

Sources: Reuters, Anne Harding, Meth Use During Pregnancy Injures Mom and Baby, July 29, 2010

Obstetrics and Gynecology, Good, Meadow M. DO; Solt, Ido MD; Acuna, Joann G. MD; Rotmensch, Siegfried MD; Kim, Matthew J. MD, Methamphetamine Use During Pregnancy: Maternal and Neonatal Implications, August 2010

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