Maternal characteristics and pregnancy outcomes among illicit drug-using women in an urban setting

Factors associated with drug use during pregnancy and breastfeeding among females who use drugs (FWUDs) in Malaysia

Females who use drugs (FWUDs) are at risk of continuing illicit substance use during pregnancy and breastfeeding. We investigated the prevalence rates and factors associated with these practices in a sample of 200 FWUDs recruited from a publicly-run drug rehabilitation center. A semi-structured questionnaire was used to collect the data. The majority (86%) was Malay (n = 171/200), currently single (71%, n = 141/200), and 51% had nine years of education. The mean age of respondents was 32.2 years (SD = 8.61). Thirty-eight percent (n = 75/200) reported ever using illicit substances during pregnancy, while 15% (n = 30/200) had used them during breastfeeding. Higher odds of using drugs during pregnancy were associated with having an intimate male drug-using partner and with persons who reported abandoning an infant in the past. Lower odds were linked with women who used heroin with ATS (relative to those who used only ATS), and shorter-term ATS (≤3 years) relative to long term ATS users. At a lower level of significance (p = 0.054), being married also lowered the odds. Higher odds of drug use during breastfeeding were associated with having an intimate male drug-using partner, and previous methadone use history, while lower odds were associated with short-term ATS use and being employed. The findings highlight the need for timely and targeted interventions to inform, engage and promote the participation of FWUDs in pre- and post-natal care services.

Maternal and Neonatal Complications of Methamphetamine Use during Pregnancy

Background

Methamphetamine abuse has been a significant problem in Thailand. The methamphetamine abuse problem also affects pregnant women. The study of pregnancy outcomes among methamphetamine users during pregnancy is currently limited.

Objective

To determine maternal and neonatal complications among methamphetamine-abusing parturients. Materials and method. This historical cohort study was conducted at Bhumibol Adulyadej Hospital (BAH), Bangkok, Thailand, between January 2017 and December 2019. The total number of women was 206 who were equally divided into a study and control group. Pregnant women who tested positive for methamphetamine in urine tests during the intrapartum period were compared to the control group with no history of drug abuse.

Results

Maternal outcomes: gestational hypertension was found to be significantly increased in the study group compared to the control group at 14.6 vs. 1.0% (OR 17.4, 95%CI 2.5-134.3). Preeclampsia with and without severe features were found at higher rates in the study group without statistical significance. There were no eclamptic cases in this study. Neonatal outcomes: preterm birth rate of pregnant women who have tested positive in their urine methamphetamine test was significantly higher than in the control group (33.3%, 11.7%, OR 3.7, 95%CI 1.8-7.7). Average birth weight in the study and control group was 2779.1 ± 486.7 and 3049.5 ± 510 gm, respectively (p value < 0.001). Low APGAR score rates of both groups also had no significant difference.

Conclusion

Methamphetamine use during pregnancy increased both maternal and neonatal complications in terms of gestational hypertension, preterm birth, and average birth weight.

Prevalence and factors associated with the use of drugs of abuse by pregnant women

Abstract Objectives: to estimate the prevalence of drug abuse in pregnant women and to associate with the variables education, family income, race and number of pregnancies. Methods: descriptive, cross-sectional, quantitative research. Developed in the municipality of Bandeirantes-PR, from June 2016 to December 2017. The population was 114 pregnant women and the dependent variables were alcohol / tobacco use and illicit drugs and the independent variables were education, race, family income and number of pregnancies. The analysis was the comparison between the variables and Microsoft Excel 2007 and SPSS 20.0 was used. It was approved by the Ethics Committee. Results: the use of drugs of abuse during pregnancy was 19.2%, presenting as a sociodemographic profile characterization the age between 19 to 29 years, predominance of nonwhite race, with study time ≤ 9 years, with income from 1 to 2 minimum wages and multiparous women. The most commonly used drug of abuse was alcohol, followed by tobacco. Concomitant use between drugs was significant with alcohol and tobacco / illicit drugs and tobacco. Conclusions: drug use had a prevalence of 19.2% and acts in conjunction with social issues and this case, intervening is necessary with an individualized care plan, thus ensuring the promotion and prevention of maternal and child health.

The epidemiologic characteristics and associated risk factors of preterm birth from 2004 to 2013 in Taiwan

Background

The rate of preterm birth has been increasing worldwide. Most preterm babies are at an increased risk of central nervous system impairments as well as respiratory and gastrointestinal complications. The aim of this study was to investigate the epidemiologic characteristics of and associated factors contributing to preterm birth in Taiwan.

Methods

Information on obstetric antecedents and risk factors for preterm birth in pregnant women was obtained from the National Health Insurance Research (NHIR) database provided by the Taiwan National Health Research Institute. All live births from 2004 to 2013 in Taiwan were included in this study.

Results

A total of 130,362 live births from 2004 to 2013 were included in this study. Overall, the average annual rate of preterm births increased by 5.3% (from 3.33% in 2004 to 5.11% in 2013). Multiple logistic regression analyses showed that nulliparous women, multifetal pregnancies, advanced mother age, history of preterm birth, history of maternal drug abuse/dependence, and maternal medical complications were positively associated with an increased risk of preterm birth (all p-values< 0.05).

Conclusion

The overall proportion of preterm births increased from 2004 to 2013 in Taiwan. Babies born preterm had a higher risk of developing morbidities and mortalities. The development of a comprehensive program to identify the high-risk group is needed for effective interventions to prevent premature birth.