(350) Methamphetamine use and mental health disorders: what are the effects on maternal and neonatal outcomes?

Objective: The objective of this study is to examine the association of methamphetamine use and mental health disorders with perinatal outcomes.

Study Design: This is a retrospective cohort study using California linked vital statistics and hospital discharge data from 2008 to 2020. We included singleton, non-anomalous gestations delivered between 23 and 42 weeks and excluded polysubstance use. Methamphetamine use and mental health disorders (depression, anxiety, bipolar disorder, schizophrenia) were identified using ICD-9 and ICD-10 codes. Chi-square tests and multivariable Poisson regression models were used.

Results: 4,602,896 individuals were included, 0.34% had methamphetamine use, 2.79% had mental health disorders, and 0.04% had both methamphetamine use and mental health disorders. Compared to individuals without methamphetamine use or a mental health disorder, individuals with both methamphetamine use and a mental health disorder had significantly higher risk of all maternal outcomes, including non-severe hypertensive disorders (8.4% vs 4.7%; aRR=1.93; 95% CI 1.67, 2.22) and cardiovascular morbidity (1.8% vs 0.3%; aRR=4.09; 95% CI 2.82, 5.93). The increased risk of these outcomes however, was similar to individuals with methamphetamine use alone. Likewise, individuals with both methamphetamine use and a mental health disorder had a higher risk of all neonatal outcomes, including preterm birth < 37 weeks (17.8% vs 6.1%; aRR=2.29; 95% CI 2.08, 2.54) and infant death (0.8% vs 0.2%; aRR=3.43; 95% CI 2.03, 5.81). While this risk was increased compared to individuals with mental health disorders alone, the risk of adverse neonatal outcomes was similar or decreased compared to individuals with methamphetamine use alone.

Conclusion: Individuals with methamphetamine use and mental health disorders have increased risk of maternal and neonatal morbidity. The occurrence of both of these risk factors for adverse outcomes however did not appear to be synergistic.