Association Between Amphetamine Use and Pregnancy Outcomes in Women With a Hypertensive Disorder of Pregnancy [24A]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 133 Suppl 1; no. 1; p. 16S
• Main Authors: Speranza, Rosa J, Greiner, Karen S, Rincon, Monica, Beeraka, Sridivya S, Burwick, Richard M
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2019
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000559371.88205.0a

INTRODUCTION:Amphetamine use in pregnancy is associated with adverse outcomes, but the association with hypertensive disorders is not well categorized. The purpose of this study was to demonstrate the relationship between amphetamine use and outcomes among women with hypertensive disorders in pregnancy. METHODS:Retrospective cohort study of subjects with hypertensive disorders of pregnancy that delivered at a single institution (Oct. ʼ13-April ʼ18). Utilizing discharge codes and individual chart review, subjects were stratified into two groups by amphetamine usecurrent vs. non-users. We assessed final hypertensive diagnosis, severe features of preeclampsia, and neonatal or maternal outcomes. Differences were analyzed by Fisherʼs exact, t-test, and logistic regression, with α=0.05. RESULTS:From 10,833 deliveries, 13.7% were classified with a hypertensive disorder of pregnancy of which 2.2% actively used amphetamines during pregnancy. Active users were more likely to be diagnosed with gestational hypertension and preeclampsia with severe features (p=0.009), and more often had severe range diastolic blood pressure (p=0.009). Adverse outcomes were increased for current amphetamine users when adjusting for maternal characteristics, and the odds of any severe feature of preeclampsia was 4.17 times greater compared to non-users in the fully adjusted model (95% CI1.11-15.71). However, when adjusting for other substance use, the association between amphetamines and composite maternal or neonatal outcomes was attenuated. CONCLUSION:Amphetamine users are more likely to be diagnosed with gestational hypertension and preeclampsia with severe features. Additionally, the concomitant use of other substances highlights the need to identify these patients at risk of adverse maternal and neonatal outcomes.