title: The relationship between maternal opiate use, amphetamine use and smoking on fetal growth.
abstract: BACKGROUND
  Opiate and amphetamine use during pregnancy is frequently associated with cigarette smoking. The negative effects on fetal growth from nicotine combined with opiates or amphetamines during pregnancy are not well documented.
  
  
  OBJECTIVE
  To investigate the relationship between maternal opiate or amphetamine use and smoking on fetal growth.
  
  
  METHODS
  A retrospective study was performed comparing pregnancies affected with either opiates or amphetamines with individually matched controls. All mothers smoked cigarettes during pregnancy. The outcome measures included changes in fetal abdominal circumference, head circumference and femur length during the second half of pregnancy and weight, length and head circumference at birth.
  
  
  RESULTS
  There were 91 opiate- and 37 amphetamine-affected pregnancies. Deviations from normative data only became apparent from the third trimester. The proportion of infants with a gestation-adjusted birthweight below the 10th percentile was not significantly different in the opiate group compared to their controls 35 (38%). However, there was a significant difference in proportions in the amphetamine group and their controls (P < 0.001). We then compared antenatal growth patterns between the amphetamine group and their controls. Amphetamine-exposed fetuses showed comparable growth parameters in the second trimester but significantly larger head and abdominal circumferences and longer femoral lengths in the third trimester than their respective controls (P < 0.05 for all).
  
  
  CONCLUSIONS
  When combined with cigarette smoking, opiates had no observed independent effect on birth parameters. Unexpectedly, in the amphetamine group, the negative effects of smoking on growth were altered in late pregnancy.
authors.affiliation: Department of Paediatrics, Sydney Medical School - Nepean, The University of Sydney, Penrith, NSW, Australia.
authors.forename: Corinne
authors.initials: C
authors.lastname: Delsing
authors.forename: Ellen
authors.initials: E
authors.lastname: Van Den Wittenboer
authors.forename: Anthony J W
authors.initials: AJ
authors.lastname: Liu
authors.forename: Michael John
authors.initials: MJ
authors.lastname: Peek
authors.forename: Ann
authors.initials: A
authors.lastname: Quinton
authors.forename: Max
authors.initials: M
authors.lastname: Mongelli
authors.forename: Alison
authors.initials: A
authors.lastname: Poulton
authors.forename: Ralph
authors.initials: R
authors.lastname: Nanan
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000196:embryology; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications*; D000704:Analysis of Variance; D001724:Birth Weight; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000196:embryology; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000209:etiology*; D006257:Head / Q000000981:diagnostic imaging / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D009293:Opioid-Related Disorders / Q000150:complications*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D016216:Ultrasonography, Prenatal; D055815:Young Adult