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 Nationwide, between 2008-2009 and 2014-2015, the proportion of
babies born exposed to amphetamines - mostly meth - doubled from 1.2
infants for every 1,000 hospital births to 2.4 infants out of every
1,000 hospital births, the study found. By the end of the study
period, the highest proportion of babies exposed to meth was in the
rural West, where 11.2 babies in every 1,000 were exposed to
amphetamine.
From 2004-2005 to 2014-2015, opioid use among pregnant women
quadrupled, from 1.5 infants for every 1,000 hospital births to 6.5
babies out of every 1,000 hospital births, the study also found. By
the end of the study period, the highest proportion of babies
exposed to opioids was in the rural Northeast, where 28.7 in every
1,000 babies were exposed to opioids.
For pregnant women with amphetamine use, the risk of severe maternal
complications and fatalities was 1.6 times higher than with opioid
use, researchers report in the American Journal of Public Health.
"In addition to the important efforts going toward treatment of
opioid use in pregnancy, the maternal health community should direct
attention going forward toward the use of amphetamines as well,"
said lead study author Dr. Lindsay Admon of the University of
Michigan in Ann Arbor.
Complications like preterm deliveries, dangerously high blood
pressure, heart failure, heart attacks, and blood transfusions were
all more common among pregnant women who used amphetamines than
pregnant women who used opioids, the study found.
There are treatments that can counter the effects of opioids, but
nothing can block the effects of amphetamines, the study authors
note.
Amphetamine use can cause vasoconstriction, or tightening of the
blood vessels. In addition to complications for mothers, this can
also restrict fetal growth and increase the risk of neurological
problems for infants.
The analysis included about 47 million deliveries at U.S. hospitals.
An estimated 82,254 deliveries included one or more amphetamine use
diagnoses, and 170,164 included one or more opioid use diagnoses.
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Pregnant women who used these drugs were more likely to be white,
from lower-income communities and insured by Medicaid or other
public health programs.
Costs for delivery hospitalizations were higher with drug use, the
study also found. For women using amphetamines, the average cost was
$5,700, compared with $5,400 for women using opioids and $4,600 for
other hospital deliveries.
The study can't prove whether or how drug use might directly impact
health outcomes or costs of care for mothers or babies. It's also
possible that results from hospital deliveries don't reflect what
would happen for women who deliver babies in other settings,
although most U.S. babies are born in hospitals.
Even so, the results show that the opioid crisis isn't the only drug
problem impacting maternal and child health in the U.S., said Joshua
Brown of the University of Florida College of Pharmacy in
Gainesville.
"As a nation, we have been very focused on opioids and neonatal
alcohol syndrome in newborns," Brown, who wasn't involved in the
study, said by email.
"This research is a reality check to recall that there are other
substances of abuse that are being used by pregnant mothers," Brown
added. "Given the disproportionate burden of substance use disorders
in rural areas, there's a tremendous need for access to treatment
options, screenings, and outreach to reduce all substance abuse
during pregnancy whether that be prescription or illicit use of
amphetamines, opioids, cannabis, tobacco, etc."
SOURCE: http://bit.ly/2FWCJgw American Journal of Public Health,
online November 29, 2018.
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