Abstract

Introduction: Methamphetamine use puts the woman at risk of disrupted parenting, infant removal and potential for poorer infant outcomes including preterm birth, low birth weight, congenital anomalies and neurodevelopmental impairments that persist into adulthood. Early identification in infants of risk factors related to methamphetamine exposure will facilitate timely and appropriate interventions during this critical developmental period. These risk factors for the infant include concerns such as exposure to methamphetamine and other drugs in utero, tobacco smoking, poorer socioeconomic factors, separation after birth, exposure to high maternal stress during pregnancy, and trauma. The evidence is clear that early detection and intervention results in improved long term outcomes.

Method: 115 pregnant women from 220 using Methamphetamine were recruited from July to December 2017 and were administered a structured questionnaire about their drug and alcohol use during each trimester of pregnancy. Basic demographic data on maternal and infant details were collected. The ages and stages questionnaire was administered at 4 and 12 months and included age-specific questions to assess infants. Written informed consent was obtained from all women prior to participation.

Results: 112 women completed the study. The majority (93%) of women were unemployed, used one gram of methamphetamine sometimes daily (50.9%) used it intravenously (67.9%) and smoked more than 10 cigarettes (tobacco) per day (87.5%). Polysubstance use was common (17.9%). Involvement with child protection and family support services was common throughout pregnancy and the postpartum period (53%). The social workers in the team manage child protection with the Department of Child Protection and Family Support (CPFS). They assess the protective factors of the parents and the risk factors associated with maternal drug use. Methamphetamine initiation occurred at a mean age of 13 years. During pregnancy, some women reported that they had overdosed as a result of their MA use (15.4%). Ages and Stages Questionnaire (ASQ-3) were completed on 82% (n=89) of infants at four months and 69% (n=75) at 12 months. Infants who scored in the problem range of at least one developmental area at four months accounted for 39.3% of the infants assessed compared to 49.3% at 12 months.

Conclusion: Our findings provide valuable insights regarding the use of methamphetamine in pregnancy. They highlight the complex needs of pregnant methamphetamine using women. Around 50% of infants were of concern in at least one developmental area suggesting that surveillance should be included in routine practice.

Keywords: Methamphetamine; Ages and stages screening; High-risk populations; Women and newborn drug and alcohol service