Potential Effects of Methamphetamine Exposure on Prenatal and Neonatal Health
Methamphetamine, commonly referred to as ‘meth’, is a synthetic stimulant that can be manufactured in home-made labs using chemicals that are available to any consumer. The use and abuse of meth have reached epidemic proportions in the United States. The number of people using meth peaked in 2005 after when federal and state regulations restricted the sale of pseudoephedrine Recently, however, the import of cheap meth from Mexico has prompted levels of use that exceed those recorded in 2005, with almost twice as many users (11,600) seeking treatment for addiction to the substance. Use is concentrated in the southern, Midwestern, and western regions of the U.S. (Vestal, 2017). This resurgence in use refocuses the concern of the healthcare community on the harmful effects of the abuse of this drug, including the effect on infants born to mothers who use it during pregnancy.
Meth is highly addictive and long-term use may cause a variety of physical and psychological injuries, including heart attacks, strokes, and psychosis. Chronic use may cause permanent changes to levels of dopamine in the brain. Dopamine is a neurotransmitter that is active in regulating the pleasure and reward neural pathways. A meth addict may lose the ability to produce sufficient dopamine and related neurotransmitters due to the effect of the drug on the brain. The addict becomes dependent on the effects of the drug which mimic the action of the depleted naturally produced neurotransmitters. Withdrawal from meth usually involves severe fatigue, depression, anxiety and irritability (Winslow, Voorhees & Pehl, 2007, pp. 1170-1172).
Given the effects of meth on an adult’s physical and psychological health, one can only imagine its damaging effect on fetal and neonatal health. Meth does cross the placental barrier, so expectant mothers using the substance are exposing their unborn children to its toxins. Stewart and Meeker (1997) reviewed eight cases of prenatal and neonatal deaths among mothers using meth. The authors analyzed samples of fetal and neonatal blood (and liver and brain tissue, in one case) from the deceased fetuses and infants for the presence of byproducts of meth. The level of byproducts was listed with the cause of death for each case. Pathology reports listed maternal abuse of methamphetamine as a contributing or complicating factor in each case, while the causes of death included prematurity, stillbirth, intrauterine death, pneumonia, and ‘unknown’ (Stewart ; Meeker, 1997, p. 516).
A developing fetus is most vulnerable to exposure to damaging substances during the first trimester, when all of the major organs and most systems are formed. The nervous system remains susceptible to the negative impact of environmental influences throughout all three trimesters. In the second and third trimester, the likelihood of miscarriage is significantly increased by the use of substances like meth. Specific physical conditions caused by fetal exposure to meth include lower blood oxygen levels and abnormal levels of other blood gases, increased blood sugar, fetal acidosis, and decreased uterine blood flow. Increases in maternal and fetal blood pressure are also common. Increased maternal blood pressure can lead to placental abruption, which results in spontaneous abortion. Increased fetal blood pressure can lead to strokes, resulting in brain damage to the fetus (Stewart ; Meeker, 1997, p. 517).
Methamphetamine is a particularly addictive drug with severe physical and psychological consequences related to chronic use. Developing fetuses and neonates are particularly vulnerable to the toxic effects of this substance. The recent increase in availability of this drug mandates an increase in screening and treatment programs for individuals who abuse it, with special emphasis on intervention for women who are pregnant.