Maternal and fetal outcomes of narcotic substance abuse, cigarette smoking, and unsafe drugs during pregnancy

Substance abuse and smoking have crossed many social, economic, and geographical borders today, and are among major health problems that endanger a multitude of population groups including the pregnant mothers because of their untoward maternal and fetal outcomes. This study was conducted to determine the relation between substance abuse and smoking by couples during pregnancy as well as antenatal unsafe drug use by mothers and untoward maternal and fetal outcomes. A descriptive and analytic cross-sectional study was conducted on 4317 women who had the criteria for admission to postpartum wards of educational hospitals affiliated to Tehran, Iran, and Shahid Beheshti Universities of Medical Sciences in Tehran, and whose pregnancy was anyhow terminated during winter 2003. A questionnaire developed by the researchers was used for interviews and the questions were in four domains of demographic characteristics obstetric history smoking, drugs, and narcotic substance use during the recent pregnancy and untoward maternal and fetal outcomes during the same time. Logistic regression model was used to determine the relation of narcotic substance use, smoking, and drugs, as well as other independent variables with the untoward fetal and maternal outcomes. The mean age of these 4317 women was 25.8 ± 5.4 years, and the mean age of their husbands was 30.7 ± 6.1 years. From the women who participated in this study, 60 of them (1.4%) used narcotic substances, 79 (1.8%) smoke cigarettes, and 616 (14.3%) used unsafe drugs. From husbands of these women, 186 men (4.3%) used narcotic substances and 1486 (34.4%) smoke cigarettes. Unsafe drug use during pregnancy increased the odds of untoward maternal outcome (OR= 1.69, 95% CI: 1.31-2.17) and fetal untoward outcome (OR= 2.58, 95% CI: 2.07-3.22), both significant at the level of p< 0.001. Cigarette smoking by mothers also increased odds of untoward fetal outcome (OR=2.71, 95% CI: 1.52-4.48, p<0.001). Unsafe drug use and cigarette smoking by mothers during pregnancy increases the odds of untoward maternal and fetal outcomes. Therefore, preventive educational programs during pregnancy should focus on reduction and elimination of using such drugs and cigarettes.