Obstetric and Neonatal Outcomes in Pregnant Women with Methamphetamine Use Delivering at Nakhon Thai Crown Prince Hospital

Abstract

          Background: Methamphetamine use during pregnancy may adversely affect maternal and neonatal health and increase the risk of unfavorable pregnancy outcomes. However, evidence regarding these outcomes in the context of community hospitals remains limited.

          Objective: To compare obstetric and neonatal outcomes between pregnant women who used and who did not use methamphetamine at Nakhon Thai Crown Prince Hospital.

          Methods: A retrospective comparative analytical study was conducted using medical record data of pregnant women who received care at Nakhon Thai Crown Prince Hospital between October 1, 2017, and September 30, 2025. A total of 207 pregnant women were included, comprising 48 women with methamphetamine detected in urine and 159 women with no methamphetamine detected in urine. Data were analyzed using descriptive statistics, the chi-square test, Fisher’s exact test, independent t-test, Mann–Whitney U test, and multiple logistic regression analysis.

          Results: Pregnant women with methamphetamine detected in urine had a significantly higher proportion of inadequate antenatal care than those without detected methamphetamine (66.7% vs. 25.1%; p < .001). They also had significantly higher rates of preterm birth (31.3% vs. 10.0%; p = .001), preeclampsia (12.5% vs. 3.1%; p = .021), and low birth weight (33.3% vs. 9.4%; p < .001). Intrauterine fetal death occurred only among women with methamphetamine detected in urine (6.3% vs. 0.0%; p = .012). Neonates in the methamphetamine-detected group had lower mean body length and admission body temperature, a higher proportion of 5-minute Apgar scores < 7, and longer hospital stays. Multiple logistic regression analysis demonstrated that methamphetamine detection in urine was independently associated with low birth weight (adjusted odds ratio [aOR] = 3.35; 95% confidence interval [CI]: 1.67–6.72) and preterm birth (aOR = 3.12; 95% CI: 1.55–6.27).

          Conclusion: Methamphetamine detection during pregnancy was associated with adverse maternal and neonatal outcomes, particularly preterm birth and low birth weight. These findings underscore the importance of proactive substance-use screening, continuous antenatal care, and multidisciplinary care to prevent and reduce pregnancy-related complications and improve maternal and neonatal outcomes.