Maternal characteristics and pregnancy outcomes among illicit drug-using women in an urban setting

Objective: To identify characteristics and pregnancy outcomes among pregnant illicit drug users living in an urban area, and to describe trends in drug use over an 8-year period.

Materials and methods: Data on pregnant women living in the Bangkok Metropolitan Region who delivered at our institution during 2008-2015 were studied. Women with drug use (n = 197) and women without drug use (n = 787) were compared in terms of maternal characteristics and pregnancy outcomes.

Results: The pregnant drug user rate markedly rose from 0.46% in 2008 to 1.28% in 2015. All pregnant drug users consumed amphetamine-type stimulants (ATS). The most important factor related to drug use was smoking (adjusted odds ratio [aOR] 41.03, 95% confidence interval [CI] 18.90-89.04). Other significant characteristics were teenage pregnancy (aOR 1.78, 95% CI 1.01-3.18), low level of education (aOR 4.97, 95% CI 1.18-20.90 for secondary school and aOR 5.61, 95% CI 1.28-24.49 for primary school or lower), and inadequate number of antenatal visits (aOR 2.20, 95% CI 1.16-4.17 for 1-3 visits and aOR 14.05, 95% CI 7.54-26.16 for no visit). Women of non-Thai ethnicity were less likely to use drugs (aOR 0.15, 95% CI 0.04-0.54). Pregnant drug users had a significantly higher risk of anemia (aOR 1.73, 95% CI 1.05-2.85), preterm delivery (aOR 2.35, 95% CI 1.29-4.29), low birth weight (aOR 2.26, 95% CI 1.23-4.17) and small for gestational age infants (aOR 3.19, 95% CI 1.39-7.33), but lower risk of cesarean section (aOR 0.43, 95% CI 0.21-0.86) than non-drug users.

Conclusion: Compared to urban pregnant women without drug use, women who consumed drugs were younger, had lower level of education, poorer self-care and poorer pregnancy outcomes. ATS was the single most commonly used drug.