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Am J Perinatol 2012; 29(05): 391-400
DOI: 10.1055/s-0032-1304818
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prenatal Methamphetamine Exposure and Short-Term Maternal and Infant Medical Outcomes

Rizwan Shah
1   Blank Hospital Regional Child Protection Center, Iowa Health, Des Moines, Iowa
,
Sabrina D. Diaz
2   LABiomed Institute at Harbor–UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California
,
Amelia Arria
3   Center on Young Adult Health and Development, University of Maryland, School of Public Health, College Park, Maryland
,
Linda L. LaGasse
4   Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island
,
Chris Derauf
5   John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
,
Elana Newman
6   Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
,
Lynne M. Smith
2   LABiomed Institute at Harbor–UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California
,
Marilyn A. Huestis
7   Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
,
William Haning
5   John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
,
Arthur Strauss
8   Miller Children's Hospital at Long Beach Memorial Medical Center, Long Beach, California
,
Sheri Della Grotta
4   Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island
,
Lynne M. Dansereau
4   Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island
,
Mary B. Roberts
4   Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island
,
Charles Neal
5   John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
,
Barry M. Lester
4   Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island
› Author Affiliations
Further Information

Publication History

19 May 2011

08 November 2011

Publication Date:
07 March 2012 (online)

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Abstract

Objective Examine maternal and infant medical outcomes of prenatal exposure to methamphetamine (MA).

Study Design Four hundred and twelve mother-infant pairs (204 MA-exposed and 208 unexposed matched comparisons) were enrolled in the Infant Development, Environment and Lifestyle (IDEAL) study. Exposure was determined by maternal self-report during this pregnancy and/or positive meconium toxicology. Maternal interviews assessed prenatal drug use, pregnancy course, and sociodemographic information. Medical chart reviews provided medical history, obstetric complications, infant outcomes, and discharge placement.

Results MA-using mothers were more likely to be poor, to have a psychiatric disorder/emotional illness and less prenatal care, and to be less likely to breast-feed their infant than comparison mothers. After adjusting for covariates, MA-exposed infants were more likely to exhibit poor suck, to have smaller head circumferences and length, to require neonatal intensive care unit (NICU) admission, and to be referred to child protective services (CPS). Several outcomes previously reported from studies that lacked adequate control groups or adjustment for covariates were not significantly different in this study.

Conclusion Prenatal MA exposure is associated with maternal psychiatric disorder/emotional illness, poor suck, NICU admission, and CPS involvement, and MA-exposed infants were less likely to be breast-fed; however, the absence of many serious complications, such as fetal distress, chronic hypertension, preeclampsia, placenta previa, abruptio placentae, and cardiac defects, suggests confounding variables influenced prior studies.

Keywords

amphetamine - methamphetamine - drug - antenatal - neonate
 

  • References

  • 1 Substance Abuse and Mental Health Services Administration. Results from the 2007 National Survey on Drug Use and Health: National Findings. NSDUH Series: 2008 H-34
    PubMedGoogle Scholar
  • 2 Kuczkowski KM. The effects of drug abuse on pregnancy. Curr Opin Obstet Gynecol 2007; 19: 578-585
    CrossrefPubMedGoogle Scholar
  • 3 Plessinger MA. Prenatal exposure to amphetamines. Risks and adverse outcomes in pregnancy. Obstet Gynecol Clin North Am 1998; 25: 119-138
    CrossrefPubMedGoogle Scholar
  • 4 Bartu A, Dusci LJ, Ilett KF. Transfer of methylamphetamine and amphetamine into breast milk following recreational use of methylamphetamine. Br J Clin Pharmacol 2009; 67: 455-459
    CrossrefPubMedGoogle Scholar
  • 5 Ganapathy VV, Prasad PD, Ganapathy ME, Leibach FH. Drugs of abuse and placental transport. Adv Drug Deliv Rev 1999; 38: 99-110
    CrossrefPubMedGoogle Scholar
  • 6 Good MM, Solt I, Acuna JG, Rotmensch S, Kim MJ. Methamphetamine use during pregnancy: maternal and neonatal implications. Obstet Gynecol 2010; 116 (2 Pt 1) 330-334
    CrossrefPubMedGoogle Scholar
  • 7 Eriksson M, Larsson G, Winbladh B, Zetterström R. The influence of amphetamine addiction on pregnancy and the newborn infant. Acta Paediatr Scand 1978; 67: 95-99
    CrossrefPubMedGoogle Scholar
  • 8 Eriksson M, Larsson G, Zetterström R. Amphetamine addiction and pregnancy. II. Pregnancy, delivery and the neonatal period. Socio-medical aspects. Acta Obstet Gynecol Scand 1981; 60: 253-259
    CrossrefPubMedGoogle Scholar
  • 9 Oro AS, Dixon SD. Perinatal cocaine and methamphetamine exposure: maternal and neonatal correlates. J Pediatr 1987; 111: 571-578
    CrossrefPubMedGoogle Scholar
  • 10 Elliott RH, Rees GB. Amphetamine ingestion presenting as eclampsia. Can J Anaesth 1990; 37: 130-133
    CrossrefPubMedGoogle Scholar
  • 11 Samuels SI, Maze A, Albright G. Cardiac arrest during cesarean section in a chronic amphetamine abuser. Anesth Analg 1979; 58: 528-530
    PubMedGoogle Scholar
  • 12 Smith L, Yonekura ML, Wallace T, Berman N, Kuo J, Berkowitz C. Effects of prenatal methamphetamine exposure on fetal growth and drug withdrawal symptoms in infants born at term. J Dev Behav Pediatr 2003; 24: 17-23
    CrossrefPubMedGoogle Scholar
  • 13 Little BB, Snell LM, Gilstrap III LC. Methamphetamine abuse during pregnancy: outcome and fetal effects. Obstet Gynecol 1988; 72: 541-544
    PubMedGoogle Scholar
  • 14 Oei J, Abdel-Latif ME, Clark R, Craig F, Lui K. Short-term outcomes of mothers and infants exposed to antenatal amphetamines. Arch Dis Child Fetal Neonatal Ed 2010; 95: F36-F41
    CrossrefPubMedGoogle Scholar
  • 15 McElhatton PR, Pughe KR, Evans C, Porter K, Bateman DN, Thomas SH. Is exposure to amphetamine-like drugs in pregnancy associated with malformations?. J Toxicol Clin Toxicol 2000; 38: 195-196
    PubMedGoogle Scholar
  • 16 Torfs CP, Velie EM, Oechsli FW, Bateson TF, Curry CJ. A population-based study of gastroschisis: demographic, pregnancy, and lifestyle risk factors. Teratology 1994; 50: 44-53
    CrossrefPubMedGoogle Scholar
  • 17 Derauf C, LaGasse LL, Smith LM , et al. Demographic and psychosocial characteristics of mothers using methamphetamine during pregnancy: preliminary results of the infant development, environment, and lifestyle study (IDEAL). Am J Drug Alcohol Abuse 2007; 33: 281-289
    CrossrefPubMedGoogle Scholar
  • 18 Smith LM, Lagasse LL, Derauf C , et al. Prenatal methamphetamine use and neonatal neurobehavioral outcome. Neurotoxicol Teratol 2008; 30: 20-28
    CrossrefPubMedGoogle Scholar
  • 19 Nguyen D, Smith LM, Lagasse LL , et al. Intrauterine growth of infants exposed to prenatal methamphetamine: results from the infant development, environment, and lifestyle study. J Pediatr 2010; 157: 337-339
    CrossrefPubMedGoogle Scholar
  • 20 Smith LM, LaGasse LL, Derauf C , et al. The infant development, environment, and lifestyle study: effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth. Pediatrics 2006; 118: 1149-1156
    CrossrefPubMedGoogle Scholar
  • 21 Bauer CR, Shankaran S, Bada HS , et al. The Maternal Lifestyle Study: drug exposure during pregnancy and short-term maternal outcomes. Am J Obstet Gynecol 2002; 186: 487-495
    CrossrefPubMedGoogle Scholar
  • 22 Lester BM, Tronick EZ, LaGasse L , et al. The maternal lifestyle study: effects of substance exposure during pregnancy on neurodevelopmental outcome in 1-month-old infants. Pediatrics 2002; 110: 1182-1192
    CrossrefPubMedGoogle Scholar
  • 23 Della Grotta S, LaGasse LL, Arria AM , et al. Patterns of methamphetamine use during pregnancy: results from the Infant Development, Environment, and Lifestyle (IDEAL) Study. Matern Child Health J 2010; 14: 519-527
    CrossrefPubMedGoogle Scholar
  • 24 Richardson GA, Hamel SC, Goldschmidt L, Day NL. Growth of infants prenatally exposed to cocaine/crack: comparison of a prenatal care and a no prenatal care sample. Pediatrics 1999; 104: e18
    CrossrefPubMedGoogle Scholar
  • 25 Shankaran S, Das A, Bauer CR , et al. Association between patterns of maternal substance use and infant birth weight, length, and head circumference. Pediatrics 2004; 114: e226-e234
    CrossrefPubMedGoogle Scholar
  • 26 Hollingshead AB. Four factor index of social status. New Haven, CT: Department of Sociology, Yale University; 1975
    Google Scholar
  • 27 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87: 163-168
    CrossrefPubMedGoogle Scholar
  • 28 Benningfield MM, Arria AM, Kaltenbach K , et al. Co-occurring psychiatric symptoms are associated with increased psychological, social, and medical impairment in opioid dependent pregnant women. Am J Addict 2010; 19: 416-421
    CrossrefPubMedGoogle Scholar
  • 29 Cruickshank CC, Dyer KR. A review of the clinical pharmacology of methamphetamine. Addiction 2009; 104: 1085-1099
    CrossrefPubMedGoogle Scholar
  • 30 Marshall BD, Werb D. Health outcomes associated with methamphetamine use among young people: a systematic review. Addiction 2010; 105: 991-1002
    CrossrefPubMedGoogle Scholar
  • 31 Zweben JE, Cohen JB, Christian D , et al; Methamphetamine Treatment Project. Psychiatric symptoms in methamphetamine users. Am J Addict 2004; 13: 181-190
    CrossrefPubMedGoogle Scholar
  • 32 Glasner-Edwards S, Mooney LJ, Marinelli-Casey P, Hillhouse M, Ang A, Rawson RA ; Methamphetamine Treatment Project Corporate Authors. Psychopathology in methamphetamine-dependent adults 3 years after treatment. Drug Alcohol Rev 2010; 29: 12-20
    PubMedGoogle Scholar
  • 33 Terplan M, Smith EJ, Kozloski MJ, Pollack HA. Methamphetamine use among pregnant women. Obstet Gynecol 2009; 113: 1285-1291
    CrossrefPubMedGoogle Scholar
  • 34 Catanzarite VA, Stein DA. “Crystal” and pregnancy—methamphetamine-associated maternal deaths. West J Med 1995; 162: 454-457
    PubMedGoogle Scholar
  • 35 Nordstrom-Klee B, Delaney-Black V, Covington C, Ager J, Sokol R. Growth from birth onwards of children prenatally exposed to drugs: a literature review. Neurotoxicol Teratol 2002; 24: 481-488
    CrossrefPubMedGoogle Scholar
  • 36 Hall W, Hando J. Route of administration and adverse effects of amphetamine use among young adults in Syndney, Australia. Drug Alcohol Rev 1994; 13: 277-284
    CrossrefPubMedGoogle Scholar
  • 37 Ujike H, Sato M. Clinical features of sensitization to methamphetamine observed in patients with methamphetamine dependence and psychosis. Ann N Y Acad Sci 2004; 1025: 279-287
    CrossrefPubMedGoogle Scholar