Maternal and neonatal effects of substance abuse during pregnancy: our ten-year experience

Yonsei Med J. 2008 Oct 31;49(5):705-13. doi: 10.3349/ymj.2008.49.5.705.


Purpose: The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country.

Materials and methods: Data on pregnancies complicated by illicit drug abuse (n = 85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group.

Results: During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score < or = 7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers.

Conclusion: Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.

MeSH terms

  • Adult
  • Apgar Score
  • Birth Weight
  • Croatia / epidemiology
  • Female
  • Heroin / adverse effects
  • Heroin Dependence / complications*
  • Heroin Dependence / drug therapy
  • Heroin Dependence / epidemiology
  • Humans
  • Incidence
  • Infant Mortality
  • Infant, Newborn
  • Maternal Exposure*
  • Methadone / adverse effects
  • Methadone / therapeutic use
  • Neonatal Abstinence Syndrome / epidemiology
  • Pregnancy
  • Pregnancy Complications / chemically induced*
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Outcome*


  • Heroin
  • Methadone