1Associated Professor of neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2PhD Candidate in Epidemiology, Mashhad University of Medical Sciences, Mashhad, Iran
3BSc in Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
4General physician, Mashhad University of Medical Sciences, Mashhad, Iran
5Department of Health, MD-MPH,Mashhad University of Medical Sciences, Mashhad, Iran
Drug abuse in pregnancy is not uncommon, and the use of illicit opioids during pregnancy is associated with an increased risk of adverse outcomes. The aim of the study was to assess neonatal outcome of pregnancy with maternal addiction. Materials and Methods: In this cohort study we assessed 100 pregnant women 15 -49 years old. To identify drug exposure was used self- questionnaire (Self-Report). Data on pregnancies complicated by illicit drug abuse (n = 50) were collected during a 2-year period (2014 - 2016) at Hospitals affiliated to Mashhad University of medical sciences. Data on the type of drug, course of gestation and labor, and on neonatal complications outcome were considered. Medical records on all non-dependence pregnancies during the study period were used as a non-exposed group (n = 50).To control possible confounding factor was used of multiple logistic regression model. Results: our results showed The risk of various congenital anomalies was 5-fold in the group of children born to addicted mothers (RR = 5.65, 95% CI: 0.27-114.7). Also RDS (RR=5.1, 95% CI: 1.16-22.3), meconial amniotic fluid (RR=2.26, 95% CI: 0.21-24.1), NICU admission (RR=3.07, 95% CI: 1.93-4.88), neonatal seizure (RR=5.38, 95%CI: 1.97-14.64), neonatal hypoglycemia (RR=2.26, 95% CI: 0.60-8.54) were significantly more common in the group of pregnant addicts. Conclusion: Addiction pregnancies must be considered as high-risk pregnancies according to perinatal outcome. We should prepare Appropriate obstetric and neonatal care in these pregnancies.
American Psychiatric Association.Diagnostic and statistical Manual o Mental Disorders.4th Text Revision ed.Washington,DC:American psychiatric Association ,2000.
Sadeghi M, Maghsuodlu M. National guidelines for hospital In drug-dependent mothers, 1th, 2012
Schempf AH. Illicit drug use and neonatal outcomes: a critical review. Obstet Gynecol Surv. 2007; 62(11):749-57.
Martin SL, Beaumont JL, Kupper LL. Substance use before and during pregnancy: links to intimate partner violence.Am J Drug Alcohol Abuse. 2003; 29(3):599-617.
Huestis MA, Choo RE. Drug abuse's smallest victims: in utero drug exposure. Forensic Sci Int. 2002; 128(1-2):20-30.
Kuczkowski KM. The effects of drug abuse on pregnancy. Curr Opin Obstet Gynecol. 2007; 19(6):578-85.
Ostrea Jr EM, Brady M, Gause S, et al. Drug screening of newborns by meconium analysis: a large-scale, prospective, epidemiologic study. Pediatrics 1992; 89(1):107-13.
Chasnoff IJ, Landress HJ, Barrett ME. The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas county, Florida. N Engl J Med 1990; 322(17): 1202-6.
9Kuczkowski KM. Cocaine abuse in pregnancyanesthetic implications. Intern J Obstetr Anesthesia 2002; 11(3): 204-10
William FR, Michael P. Pharmacotherapy for pregnant women with addictions. Am J Obstet Gynecol 2004; 191(6): 1885-97.
Ramezanzadeh F, Tavafian S, Vahdaninia M, et al. Maternal and fetal outcomes of narcotic substance abuse, cigarette smoking, and unsafe drugs during pregnancy; Hakim Res J 2007; 10(3): 9- 16. (Persian)
Torshizi, M.; Saadatjoo, S. A.; Farabi, M.prevalence of narcotic substance abuse and the mathernal and fetal outcomes in pregnant women. Journal of Jahrom University of Medical Sciences. 2011, Vol. 9 Issue 3, preceding p19-19. 6p.
shrifiyan J and et al. The Fate of Motherhood, Fetuses and Neonates in Drug Addicted Pregnant Women, Journal of Shahid Sadoughi University of Medical Sciences. 2011; 19(2):183-191
Sanchez ES, Biqbee JW, Fobbs W, Robinson SE, Sato Biqbee C. Opioid addiction and pregnancy: perinatal.
Butler, I, Payne, H, Mather, H, Humphrey, J and Robson, J. Department of Health. Statistical Bulletin 1997. London: HMSO, 1997.
Abdel-Latif ME, Bajuk B, Lui K, Oei J. Short-term outcomes of infants of substance-using mothers admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory. J Paediatr Child Health. 2007. 43:127 –133
Behnke M, Eyler FD. The consequences of prenatal substance use for the developing fetus, newborn, and young child. Int J Addict. 1993. Nov.28 (13):1341-91.
Day C, Nassirimanesh B, Shakeshaft A, Dolan K. Patterns of drug use among a sample of drug users and injecting drug users attending a General Practice in Iran. Harm Reduct J 2006;3:2.
Little BB, Snell LM, Klein VR, GilstrapLC, Knoll KA, Breckenridge JD. Maternal and fetal effects of heroin addiction during pregnancy. J Reprod Med. 1990. Feb. 35(2):159-62.
Bhuvaneswar CG, Chang G, Epstein LA, Stern TA.Cocaine and opioid use during pregnancy: prevalence and management. Prim Care Companion J Clin Psychiatry 2008; 10:59–65.
Joan Keegan, DO, Mehdi Parva, MD, Mark Finnegan, MD, Andrew Gerson, MD, Michael Belden, MD. Addiction in Pregnancy. Journal of Addictive Diseases, 29:175–191, 2010.
Mark L. Hudak, MD, Rosemarie C. Tan, MD, PhD. Neonatal Drug Withdrawal. American Academy of Pediatrics. Pediatrics. 2012;129;e540.
Sandra Mawhinney, Robin G Ashe, Joanne Lowry. Substance Abuse in Pregnancy: Opioid substitution in a Northern Ireland Maternity Unit. Ulster Med J. 2006 Sep; 75(3): 187–191.
Vucinovic M, Roje D, Vučinović Z,Capkun V, Bucat M, Banović I. Maternal and Neonatal Effects of Substance Abuse during Pregnancy: Our Ten-year Experience. Yonsei Med J. 2008.49 (5):705-713.
Kelly JJ, Davis PG, Henschke PN. The drug epidemic: effects on newborn infants and health resource consumption at a tertiary perinatal center. J Paediator Child Health 2000;36(3):262-4.
Richard A. Heroin addiction and pregnancy. West J Med 2006; 134(7): 506-51.
Terplan M, Wright T. The effects of cocaine and amphetamine use during pregnancy on the newborn: Myth versus Reality. J addict dis 2011; 30(1): 1-5.
Mahmoudian AR, Boroushaki MT, Molkizadeh F. Assessment of some complications obtained from malemices addiction to morphine on first generation of offspring. Iran J Basic Med Sci 2006; 9(1(29)): 50-4.
Adam Newman, Gregory A. Davies, Kimberly Dow, Belinda Holmes, Jessica Macdonald, Sarah McKnight, Lynn Newton. Rooming-in care for infants of opioid-dependent mothers Implementation and evaluation at a tertiary care hospital. Can Fam Physician. 2015 Dec; 61(12): e555–e561
Soraya Saleh Gargari, Masoumeh Fallahian, Ladan Haghighi, Maryam Hosseinnezhad-Yazdi1, Elahe Dashti, and Kate Dolan. Maternal and Neonatal Complications of Substance Abuse in Iranian Pregnant Women. Acta Medica Iranica, Vol. 50, No. 6 (2012).