Clinical characteristics and factors affecting severity of methamphetamine withdrawal symptoms in neonates from maternal methamphetamine use

Abstract

Background: The prevalence of substance use among pregnant women is steadily rising, resulting in a range of problems in newborns. Newborns who are exposed to substances often have withdrawal symptoms, which have a negative impact on their physiological systems, requiring hospitalization and leading to higher healthcare expenses. A study on the factors that affect withdrawal symptoms in newborns, using the Neonatal Abstinence Scoring System (NAS score) to assess withdrawal symptoms, can provide healthcare providers with valuable insights for effectively monitoring and treating affected newborns, potentially reducing complications.

Objective: To analyze the clinical characteristics and identify factors that contribute to severe withdrawal symptoms in neonates born to mothers who used methamphetamine during pregnancy.

Methods: This retrospective study utilized hospital data to identify neonates who tested positive for methamphetamine in urine between 2019 and 2023. Data were collected using standardized forms and analyzed using descriptive statistics, including means, standard deviations, and logistic regression.

Results:  A total of 49 newborns were enrolled. Among them, 83.7% were male, 59.2% were born prematurely, and 65.3% had low birth weight. Out of all the newborns, 61.2% experienced mild withdrawal symptoms, indicated by a Neonatal Abstinence Scoring System (NAS score < 4). On the other hand, 38.8% of neonates exhibited severe withdrawal symptoms (NAS score ≥ 4). The length of hospital stay in the severe withdrawal symptoms group was 4.1±1.1 days. Factors affecting the severity of methamphetamine withdrawal symptoms include term neonate (≥37 weeks) (OR 4.29, 95% CI 1.15-15.97; p value 0.030), the need for neonatal resuscitation (OR 6.46, 95% CI 1.15-36.46; p value 0.035), and birth weight ≥ 2,500 grams (OR 14.08, 95% CI 3.37-58.83; p value < 0.001). Multivariate analysis identified factors associated with severe withdrawal symptoms, including a birth weight above 2,500 grams (adjusted OR 8.96, 95%CI 1.76-45.49; p value 0.008).

Conclusion: Neonates born to mothers who used methamphetamine during pregnancy experienced withdrawal symptoms. One-third of infants had severe withdrawal symptoms, highlighting the need for further studies to inform infant care for mothers who abused methamphetamine.