Ludlow Joanne P, Evans Sharon F, Hulse Gary
King Edward Memorial Hospital, University of Western Australia, Perth, Australia.
Aust N Z J Obstet Gynaecol. 2004 Aug;44(4):302-6. doi: 10.1111/j.1479-828X.2004.00221.x.
To determine the obstetric and perinatal outcomes of women using illicit drugs during pregnancy by substance group.
A retrospective audit of obstetric and perinatal outcomes in women who used opiates or amphetamines during their pregnancy and delivered at King Edward Memorial Hospital (KEMH), Perth, Australia between December 1997 and April 2000 was performed. Maternal, fetal and neonatal parameters were assessed. These were compared with obstetric and perinatal data recorded by the Health Department of Western Australia (HDWA) for the 25,291 deliveries of 25,677 infants in 1998.
Between December 1997 and April 2000 91 opiate-using and 50 amphetamine-using women were identified and included in the analysis. Both groups of drug-using women were younger (opiates P = 0.001, amphetamines P = 0.001) than the general population. There was a higher incidence of aboriginality (P = 0.001) in the amphetamine group. In the opiate-using group multiparity (P = 0.0001) and anaemia (P = 0.0001) were higher. Illicit drug-using women had a higher incidence of hepatitis C (opiates P = 0.001, amphetamines P = 0.003), and a greater need for pharmacological analgesia for labour and delivery (opiates P = 0.007, amphetamines P = 0.042). Their infants were significantly more likely to deliver at less than 37 weeks' gestation (opiates P = 0.0001, amphetamines P = 0.001), to have a birthweight of less than 2.5 kg (P = 0.0001), be small for gestational age and require admission to the special care nursery (P = 0.0001). Infants born to women in the amphetamine group were more likely to have an Apgar score < 7 (P = 0.0001) recorded. Infants of women in the opiate group required more resuscitation (P = 0.05).
Women who use illicit drugs are more likely to experience adverse obstetric and perinatal outcomes than women in the general population. Differences are seen depending on the type of illicit drug used. These findings need to be replicated in a larger prospective cohort to highlight management requirements of these women and their infants. Further information is required about the effects of amphetamines in pregnancy.
按药物类别确定孕期使用非法药物的妇女的产科及围产期结局。
对1997年12月至2000年4月期间在澳大利亚珀斯爱德华国王纪念医院（KEMH）分娩的孕期使用阿片类药物或苯丙胺类药物的妇女的产科及围产期结局进行回顾性审计。评估了孕产妇、胎儿及新生儿参数。将这些参数与西澳大利亚卫生部（HDWA）记录的1998年25,677例婴儿的25,291次分娩的产科及围产期数据进行了比较。
1997年12月至2000年4月期间，共识别出91名使用阿片类药物和50名使用苯丙胺类药物的妇女并纳入分析。两组使用药物的妇女均比普通人群年轻（阿片类药物P = 0.001，苯丙胺类药物P = 0.001）。苯丙胺类药物组原住民发生率更高（P = 0.001）。在使用阿片类药物的组中，多胎妊娠（P = 0.0001）和贫血（P = 0.0001）发生率更高。使用非法药物的妇女丙型肝炎发生率更高（阿片类药物P = 0.001，苯丙胺类药物P = 0.003），分娩时对药物镇痛的需求更大（阿片类药物P = 0.007，苯丙胺类药物P = 0.042）。她们的婴儿在妊娠不足37周时分娩的可能性显著更高（阿片类药物P = 0.0001，苯丙胺类药物P = 0.001），出生体重低于2.5千克（P = 0.0001），小于胎龄且需要入住特殊护理病房（P = 0.0001）。苯丙胺类药物组妇女所生婴儿更有可能记录到阿氏评分＜7（P = 0.0001）。阿片类药物组妇女的婴儿需要更多复苏（P = 0.05）。
与普通人群中的妇女相比，使用非法药物的妇女更有可能经历不良的产科及围产期结局。根据所使用的非法药物类型会出现差异。这些发现需要在更大的前瞻性队列中进行重复验证，以突出这些妇女及其婴儿的管理需求。需要进一步了解苯丙胺类药物在孕期的影响。
