Pregnancy hospitalizations with a diagnosis of illicit stimulant abuse in the United States, 1998-2004

Objective To examine trends in pregnancy hospitalizations with a diagnosis of illicit stimulant (cocaine or amphetamine) abuse and the prevalence of associated medical conditions.

Methods Data were obtained from the Nationwide Inpatient Sample. Hospitalization ratios per 100 deliveries for illicit stimulant abuse from 1998 to 2004 were tested for linear and quadratic trends. Chi-square analysis was used to compare hospitalization characteristics between cocaine, amphetamine and non-substance abuse groups. Nonobstetric complications were assessed among nondelivery hospitalizations while obstetric complications were evaluated among deliveries. The adjusted prevalence of medical complications for each group was calculated using logistic regression. Differences were significant at p-value < .01.

Results From 1998 to 2004, the hospitalization ratio for cocaine abuse decreased 43% as the hospitalization ratio for amphetamine abuse doubled. Pregnancy hospitalizations with a diagnosis of amphetamine abuse were concentrated in the West (82%), and were more likely to be White, younger than 24 years and located in rural locations compared with the cocaine abuse group. Most medical conditions were more prevalent in the illicit stimulant abuse groups as compared to the non-substance abuse group. When illicit stimulant groups were compared to each other, obstetric complications associated with infant morbidity such as premature delivery and poor fetal growth were more common in the cocaine abuse group, while cardiovascular disorders and hypertension complicating pregnancy were more common in the amphetamine abuse group.

Conclusion Our results confirm the adverse health effects of illicit stimulant abuse. Pregnant women presenting with acute cardiovascular symptoms should be evaluated for amphetamine abuse.