Prenatal amphetamine exposure and birth outcomes: a systematic review and metaanalysis

OBJECTIVE: The aim of this study was to systematically review the relationship between amphetamine exposure in pregnancy and birth outcomes. STUDY DESIGN: Electronic databases were searched to identify relevant studies. Data from included studies were extracted by 2 reviewers. Summary odds ratio (OR) and confidence intervals (CIs) were calculated using the random effects model. RESULTS: Ten studies were included. Significant increases in unadjusted risks of preterm birth (OR, 4.11; 95% CI, 3.05-5.55), low birth-weight (OR, 3.97; 95% CI, 2.45-6.43), and small for gestational age (OR, 5.79; 95% CI, 1.39-24.06) were identified among women ex-posed to amphetamines in pregnancy. The mean birth-weight was significantly lower among amphetamine-exposed pregnancies (mean difference, -279 g; 95% CI, -485 to -74 g). Two studies provided adjusted estimates on different outcomes, and their results were consistent with the findings from the unadjusted data. CONCLUSION: Amphetamine exposure in pregnancy is associated with adverse birth outcomes and should be identified by physicians providing antenatal care.