Methamphetamine abuse in pregnancy – Prenatal sonographic findings

Purpose: Drug abuse, particularly methamphetamine (METH) is very common in Saxony (Germany). Official reports show an increase since METH is cheap and easy available. It is a strong central nervous system stimulant, that is mainly used as a recreational drug and is associated with a high potential for abuse and dependence. The impact of prenatal METH exposure on pregnancy and development in childhood is unknown.

Material and methods: At the University Hospital of Dresden pregnancy data and sonographic fetal findings from all METH consuming pregnant women between 2011 and 2015 were retrospectively analyzed.

Results: The number of METH using pregnant women is continuously rising since 2011 and effects 1% of deliveries since 2013 at the University hospital Dresden. Between 2011 and 2015 105 METH using women were seen during pregnancy, 94 of them delivered in our hospital. Beside METH abuse 79% of women admitted nicotine and 30% Cannabis co-abuse. In 24% of cases pregnancy was detected late or without prenatal care. 32.9% were premature pregnancies, 26.6% small for gestational age (SGA) und 8.5% of cases intrauterine growth retardation. 4 cases were stillbirth. 38% of women received specialized DEGUM II ultrasonic differential screening. Sonographic abnormalities showed a broad spectrum: Ventricular septal defects (VSD), complex heart defects, cleft lip and palate and sporadic kidney abnormalities. Conspicuous was the high rate of microcephaly (6.4%).

Conclusion: METH use is an increasing problem in Saxony and problems especially arise because of a higher rate of premature or SGA-pregnancies. Specific METH related fetal abnormalities were not detected. Association with a higher rate of microcephaly might be possible. Often women were seen late in pregnancy and ultrasonic differential screening was difficult to assess. More research needs to be done to evaluate the impact of METH abuse on intra- and postnatal development of children.