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

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.

Developmental and behavioral consequences of prenatal methamphetamine exposure: A review of the Infant Development, Environment, and Lifestyle (IDEAL) study

“…Further, the MA group had a lower SES, were less likely to have a partner and were diagnosed with a psychiatric disorder/emotional illness more frequently than mothers in the comparison group (Shah et al 2012). Nearly 26% of MA exposed children had an adoptive parent as their primary caregiver (Table 1).…”

The Use of Central Nervous System Active Drugs During Pregnancy

“…Poor infant psychomotor development after maternal amphetamine [156], ecstasy [157], or methamphetamine [158,159] abuse is well known. A general effect of illicit drug use was found on oppositional defiant disorder and adult antisocial behaviour while an increased risk for ADHD did not reach statistical significance [160].…”

Detrimental effects of self-administered methamphetamine during pregnancy on offspring development in the rat

“…They also exhibited poor movement, low arousal and increased lethargy (LaGasse et al, 2012; Minnes et al, 2012; Smith et al, 2003). Beyond the neonatal stage, METH-exposed children also were more likely to have increased emotional reactivity, anxiety, and diagnoses of attention deficit hyperactivity disorder (Diaz et al, 2014; Kirlic et al, 2013; LaGasse et al, 2012; Minnes et al, 2012; Shah et al, 2012; Smith et al, 2003, 2012; van Dyk et al, 2014; Wouldes et al, 2014). While the METH exposure in utero likely plays an important role in affected development, the postnatal environment may be as important to the developing child since a negative postnatal environment characterized by as abuse or neglect has been linked to the development of psychiatric disorders in adulthood (Heim et al, 2004).…”