Amphetamine use in pregnancy: Perinatal approaches to improve maternal and neonatal outcomes

Amphetamines are highly addictive, relatively low in cost and are easily procured (Pedersen et al, 2015). Amphetamines, and the issues associated with their use, have overtaken other classes of illicit drugs since the 1990s, with the majority of female users being of childbearing age (McDonnell-Dowling and Kelly, 2015). The UK, Australia and the USA have all recorded high rates of amphetamine use (Barratt et al, 2014). Degenhardt et al (2016) have estimated that between 2013 and 2014 there were 268 000 regular users of amphetamines in Australia aged between 15-54 years of age, and 160 000 had a high level of dependency. The sharp increase in the prevalence of amphetamine use globally will require particular consideration in the planning and allocation of future health care resources. This includes maternity services, as the majority of women who use amphetamines are of childbearing age. Pregnancies associated with amphetamine use are considered to be complex and pose an increased risk of complications occurring, which may have significant health implications for both the woman and fetus/newborn (Gorman et al, 2014). It is important to note that women using amphetamines often already have suboptimal health associated with substance abuse, including periodontal issues, poor nutrition and mental health issues (Baghaie et al, 2017), and are often members of marginalised groups with complex psychosocial issues, and a history of reduced rates of health care access and attendance (Whiteford et al, 2013).