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Prenatal methamphetamine use impacts neonatal outcomes
Kalaitzopoulos DR, et al. J Addict Med. 2018;doi:10.1097/ADM.0000000000000391.
Methamphetamine use during pregnancy resulted in a decrease in infants' birth weight, height, head circumference, body length and gestational age at birth, according to results from a systematic review and meta-analysis.
However, mothers exposed to methamphetamine during pregnancy did not experience excessive pregnancy complications, according to findings published in Journal of Addiction Medicine.
"Among vulnerable populations that use methamphetamine are pregnant women," Dimitrios-Rafail Kalaitzopoulos, MD, from the unit of reproductive endocrinology, first department of obstetrics and gynecology, Aristotle University of Thessaloniki, Greece, and colleagues wrote. "Data about the effects of methamphetamine use during pregnancy are limited, as existing studies have involved small samples and have not been able to account for the possibility that mothers used other drugs apart from methamphetamine."
The investigators performed a systematic review of clinical literature and meta-analysis of retrospective, case-control studies to assess the effects of methamphetamine exposure during pregnancy on neonatal and pregnancy outcomes. Included studies compared women exposed to methamphetamine during pregnancy with controls not using methamphetamine to examine gestational age at birth, neonatal characteristics — birth weight, head circumference and body length — and prevalence of gestational hypertensive disorders.
Researchers included eight studies involving 626 women using methamphetamine during pregnancy and 2,626 controls in their meta-analysis. The results showed no statistical difference between women exposed to methamphetamine during pregnancy and controls on the incidence of preeclampsia (RR = 1.77; 95% CI, 0.75-4.14) and hypertensive complications (RR = 1.62; 95% CI, 0.37-7.06). Compared with control pregnancies, pregnancies complicated by using methamphetamine lead to:
younger gestational age at birth (mean difference [MD] = –0.9 weeks; 95% CI, –0.11 to –1.69);
lower birth weight (MD = –245 g; 95% CI, –137 to –353);
head circumference (MD = –0.88 cm; 95% CI, –0.48 to –1.28);
body length (MD = –0.94 cm; 95% CI, –0.55 to –1.32); and
Apgar score (MD = –0.94; 95% CI, –0.33 to –1.54).
"A limitation of this meta-analysis is the different methods used to identify the methamphetamine use. Pregnant women were recruited into the methamphetamine group by a combination of self-report and toxicological examinations, such as maternal urine test, meconium, or neonatal urine toxicology, self-report only or neonatal urine examination only," Kalaitzopoulos and colleagues wrote. "Neither of these methods can be considered as ideal. To obtain an accurate estimation of the drug use, all methods should be used together." – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.