Perinatal Effects of Amphetamine and Heroin Use during Pregnancy on the Mother and Infant
Pimolrat Thaithumyanon MD*, Sompop Limpongsanurak MD**, Pramote Praisuwanna MD*, Santi Punnahitanon MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Chulalongkorn University ** Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University
Objectives : To determine the perinatal impacts of heroin and amphetamine on both mothers and infants.
Materials and Methods : This is a retrospective study on the influence of amphetamine and heroin on pregnant
women and their newborn infants at King Chulalongkorn Memorial Hospital in Bangkok, Thailand, between
January 1997 and December 2002. The medical and demographic data of both mothers and infants were
evaluated. Comparison of the consistent drug effects of these 2 drugs on the mothers and infants were also
performed.
Results : Two hundred and eleven women were identified. There were 178 (84.4%) and 33 (15.6%) women
addicted to amphetamine and heroin respectively. Sixty one (28.9%) of them were polydrug users. There were
more polydrug users among heroin addicts than amphetamine addicts, (43.7% vs 27.2%, p < 0.05). Poor
obstetric history were noted in both groups of women including lack of prenatal care (74.9%), a high inci-
dence of previous abortion (22.3%), positive HIV serology test (11.1%), pre-eclampsia (5.2%), infection (3.3%)
and antepartum hemorrhage (1.9%). Drug intoxication was found in 11 amphetamine addicted mothers,
whereas 2 heroin addicts developed withdrawal symptoms during intrapartum and postpartum periods. All
infants were singleton. There was one stillbirth and 2 neonatal deaths. There was no statistical difference in
terms of sex ratio, mean birth weight, gestational age, length, head circumference and Apgar score between
the groups of amphetamine and heroin exposed infants.
The incidence of prematurity, low birth weight, IUGR and microcephaly were not statistically different
between both groups of infants. The overall incidence was 31.7%, 31.7%, 9.5% and 8.6% respectively.
Congenital anomalies were found in 5 (2.8%) amphetamine exposed infants. Thirty one out of 33
heroin exposed infants (93.9%)and 4 out of 178 amphetamine exposed infants (2.2%) developed drug with-
drawal symptoms with the mean onset of 21.5 + 16.5 hours and 10.3 + 7.5 hours respectively, p > 0.05. All
heroin withdrawal infants were successfully treated with Phenobarbital with the mean duration of treatment
of 23.7 + 11.5 days. None of the amphetamine withdrawal infants needed specific treatment. They recovered
spontaneously within 6.0 + 5.3 days. Eighteen infants were left in an orphanage or under the custody of their
relatives.
Conclusion : Amphetamine or heroin use during pregnancy can cause many serious adverse effects on both
mothers and infants. The findings in the present study are consistent with previous reports, although they
seemed to be more common and severe. Increasing awareness and improving understanding of drug abuse in
the medical, legal and social aspects are needed in order to reduce these impacts.
Keywords : Perinatal effect, Amphetamine, Heroin, Pregnancy
