Hospitalisation of children after prenatal exposure to methamphetamine

Background
Methamphetamine (MA) use increases worldwide. Little evidence is on the association between prenatal MA exposure and somatic morbidity during the first years of life.

Aim

The aim of the study was to examine morbidity in children prenatally exposed to methamphetamine by studying hospitalizations form birth up until the age of three.

Design

Nation-wide register-based cohort study using personalized IDs assigned to all citizens for data linkage.

Setting

The Czech Republic (2000-14).

Participants

Children: (1) of mothers in methamphetamine during pregnancy (n=194), (2) of methamphetamine discontinuers (n=317), (3) of illicit opioid users (n=166) and (4) born to women without documented drug abuse (n=1 294 348).

Measurements

We linked data from nationwide registries on reproductive health, hospitalization and death. Information on all in-patient contacts, length of stay, and primary and secondary diagnosis were assessed. Diagnosis was classified according to the 10th revision of International Classification of Diseases (ICD-10). We performed binary logistic regression to explore the associations between methamphetamine exposure and outcomes.

Results
No differences were found in the overall proportion of children hospitalised between the methamphetamine exposed, methamphetamine discontinuers and illicit drugs opioid users groups (47.4%, 47.0%, 53.0%), while the proportion of hospitalised children from general population was significantly lower (35.2%). There were no significant differences in risk of specific diagnoses between methamphetamine, methamphetamine discontinuers and illicit drugs opioid user groups.

In adjusted analysis, differences between methamphetamine and GP were still present when looking at infection and parasitic diseases (adjusted OddsRatio (aOR)=1.5; 95% Confidence Interval 1.0-2.2); disease of the ear and mastoid process (aOR=1.9; 1.1-3.4), conditions originating in the perinatal period (aOR=1.8; 1.0-3.0) and injury, poisoning and certain other consequences of external causes (aOR=1.6; 1.1-2.5).

Conclusions
Based on nationwide data, this study suggests that compared to relevant comparison groups, prenatal methamphetamine exposure did not increase the risk of morbidity during the first three years of life. Compared to the GP, children prenatally exposed to methamphetamine suffer from higher somatic morbidity during the first three years of life, but the risk estimates may be confounded by unmeasured lifestyle factors associated with methamphetamine use disorders.