THURSDAY, Nov. 29, 2018 -- Methamphetamine and opioid use has soared among pregnant American women, putting the health of baby and mother at risk, a new study finds.
While addiction among pregnant women has dramatically increased across the country, it disproportionally affects women living in rural America, where access to addiction treatment and prenatal care is limited, the researchers added.
"Use of both substances represents worsening public health crises," said lead researcher Dr. Lindsay Admon, an assistant professor of obstetrics and gynecology at the University of Michigan in Ann Arbor.
Although government efforts to curb methamphetamine use have been effective in the past, its use has spiked once more, she said.
Some data suggests that stopping amphetamine use in pregnancy can improve outcomes, Admon said. "But as clinicians, we need clear guidance on how to best promote cessation among pregnant patients with amphetamine use disorders."
Moreover, doctors need ways to guide patients to treatment services, particularly in rural areas where obstetric and addiction treatment services may be harder to access. In addition, addicted women may not tell their doctors about their drug use for fear of the legal consequences, Admon noted.
Another women's health expert agreed with the findings.
"This study confirms what I have been hearing clinically from providers and patients in the West that there is an unrecognized problem with amphetamines, and that the opioid crisis is now coupled with an amphetamine crisis that desperately needs monetary, treatment and recovery infrastructure support to reduce it," said Hendree Jones, a professor of obstetrics and gynecology at the University of North Carolina in Chapel Hill.
Furthermore, the study provides compelling data that underscores the lack of addiction treatment resources for women of childbearing age, said Jones, who wasn't involved with the research.
For the study, Admon and colleagues collected data on 47 million births in U.S. hospitals over 12 years.
They found that the number of births among women addicted to amphetamine, mostly methamphetamine, doubled from 2008 to 2015, from 1.2 per 1,000 births to 2.4 per 1,000 births.
In addition, opioid use more than quadrupled from 1.5 per 1,000 births between 2004 and 2005 to 6.5 per 1,000 between 2014 and 2015.
Using amphetamine during pregnancy increases the odds of moms dying or having serious medical complications by nearly two times of that of women using opioids, the researchers found.
Also the risk of preterm delivery, preeclampsia or eclampsia, heart failure or heart attack, and the need for a blood transfusion were higher among moms using amphetamine, compared with those using opioids, according to the study.
The main risk to infants born to addicted mothers is neonatal abstinence syndrome. Basically, the infants are born addicted to the drug mom was using and they go through withdrawal, much as an adult does when they stop taking the drug.
Symptoms such as body shakes, tremors, breathing problems, diarrhea or throwing up and fever and sweating can last up to six months, according to the March of Dimes.
Often these babies need to be in neonatal intensive care units for an extended period.
Between 2014 and 2015, amphetamine use caused delivery complications in roughly 1 percent of all births in the rural West (11 per 1,000 deliveries), which was higher than the number of complications among women using opioids in most areas.
Opioid use during pregnancy was highest in rural areas of the Northeast, causing complications in nearly 3 percent of all births (29 per 1,000 deliveries).
Poor, white women on public assistance were the ones most likely to be using amphetamine and opioids, the researchers found.
In addition to using amphetamine and opioids, many of these women are also using marijuana and tobacco, said Dr. Rahul Gupta, chief medical and health officer at the March of Dimes.
"It's very troubling that of all the times in the lifecycle of an individual during pregnancy, women who are using opioids are also using tobacco," he said. "That almost seals the fate of the infant, as well as the health of the mother and the ability of the mother to take care of the child," Gupta said.
The report was published Nov. 29 in the American Journal of Public Health.
The American Pregnancy Association has more information on drug addiction and pregnancy.
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