Birth weight
Both opioid misuse and methamphetamine misuse during pregnancy have been associated with adverse effects on the birth weight of newborns.
Research indicates that opioid use during pregnancy can lead to low birth weight and other complications for the newborn [3]. Opioid use disorder among pregnant women is a significant concern, and efforts are made to prevent adverse outcomes for both the mother and the child [8].
Similarly, methamphetamine use during pregnancy has been linked to an increased risk of low birth weight. Stopping methamphetamine use at any time during pregnancy has been shown to improve birth outcomes, emphasizing the importance of timely interventions [9].
While specific studies comparing the birth weight of opiate users and methamphetamine users during pregnancy have not be done specifically, the information highlights potential adverse effects associated with both substances [10]. In our study Birth weight varied significantly among the groups (p = 0.047) Infants in the Opioid group were, on average, heavier compared to the other two groups.
This differences can be due to different cultural and Socioeconomical status of mothers who use opiates as old and Traditional drugs versus methamphetamines as new and synthetic drugs. The positive effect of methadone replacement therapy by health care providers can be another probable cause [11]. Further Research on Substance-Specific Outcomes Should be considered.
Gestational Age, SGA
This finding along with another finding of our research that the length of pregnancy and gestational age in these babies are normal led to another finding of our research that ). The rate of small for gestational age (SGA) was 0%, 12.5% and 21.4% in the opioid, MA, and opioid + MA groups, respectively (p = 0.68)
Research suggests that opioid misuse during pregnancy is associated with an increased risk of preterm birth and low birth weight [12].On the other hand, methamphetamine use in pregnancy is linked to an increased risk of low birth weight and small for gestational age babies [13].
Although The effect of drug abuse on gestational age was not confirmed by our results but the risk of being small for gestational age for infants of drug misusing mothers was evident in our results.
Route of Delivery
Although methamphetamine use during pregnancy has been associated with an increased risk of adverse outcomes, and addressing potential complications may involve decisions about the method of delivery [7]. There is limited direct information available on the specific comparison between opioid and methamphetamine misuse during pregnancy in terms of the need for caesarian section for newborns.
In our study, we did not find a significant difference in the need for cesarean delivery in the two groups which can indicate that there is no clear difference in the birth complications of these groups, However, more dedicated studies in the future seem necessary in this field.
Need To Admission and Duration of Admission
Researches indicate that both opioid misuse and methamphetamine misuse during pregnancy can contribute to prolonged hospital admissions for newborns, but the specific duration may vary based on individual cases and circumstances.
Opioid misuse during pregnancy, especially if it leads to Neonatal Abstinence Syndrome (NAS), is associated with an increased likelihood of extended hospital stays for affected newborns.
Similarly, infants born to mothers who misuse methamphetamine may also face prolonged hospital admissions due to the potential health complications associated with methamphetamine exposure during pregnancy [14,15].
In our study, there was no significant difference in the need for hospitalization of the newborn and the duration of hospitalization of the newborn in the three groups which can indicate that between three groups in the field of the severity of withdrawal symptoms, overall health of the infant, and the effectiveness of medical interventions The differences are not significant .
Need for pharmacological treatment and hospitalization duration
Past literature demonstrates that neonates born to mothers with opioid use disorders during pregnancy have historically displayed more severe neonatal abstinence syndrome (NAS) Symptomatology and required pharmacological treatment more frequently compared to neonates with in utero methamphetamine exposure [7]. For example, Smith et al. (2003), infant withdrawal signs from methamphetamine withdrawal only need pharmacologic therapy in 4% of cases [6]. However, intriguingly, our recent retrospective data challenges these long-held notions .Upon dividing our maternal-infant cohort into three distinct groups - opiate misuse, methamphetamine misuse, and multi-drug misuse during gestation - we found no statistically significant differences between groups in regards to NAS diagnosis rates using similar scoring methods to Smith et al. or infant hospital lengths of stay. Therefore, the notion that opioid withdrawal universally eclipses methamphetamine severity may require re-evaluation through rigorous designed study to elucidate the potential mediating variables resulting in equivalently increased NAS susceptibly in our sample across differing drug classes. Practical application of these findings could inform clinical screening and monitoring practices.