A Perinatal Review of Prevalence and Risk Factors for Substance Abuse Among Pregnant Women in Singapore

Drug use during pregnancy can have detrimental effects on pregnancy and can lead to poor maternal and child health outcomes. There is currently limited information available on the prevalence and risk factors for drug abuse in pregnant women in Singapore. The aims of the study are to (i) establish the prevalence of drug abuse and (ii) assess risk factors for drug abuse during pregnancy.

A perinatal review of the management of cases of substance abuse in pregnancy from 2010 to 2020 was performed. Case records of substance abuse (excluding alcohol and tobacco) over the last 10 years from 2010 to 2020 were sourced via ICD-10 Diagnosis and extracted from the medical records. Essential demographic data were subsequently collected.

There was a total of 20 women with perinatal drug abuse between 2010 and 2020. Three of the 20 women engaged in drug abuse for two of their pregnancies each, making 23 pregnancies affected by substance abuse during this period. The prevalence was low at 0.018% (23/128576) or 1 in 5,590 pregnant women. The common substance abuse was heroin with 11 cases (55.0%) and amphetamines/methamphetamines with nine cases (45.0%). High-risk factors for the pregnant substance abuser were younger age < 30 years old, Malay or Indian ethnicity and a history of smoking. In general, pregnant drug abusers book late in their pregnancy and tend to have little or no proper prenatal care and to default on their pregnancy follow-ups.

The prevalence of drug abuse among pregnant women in Singapore is low. The overall low prevalence of drug abuse nationally has contributed to low prevalence among pregnant women. Management of substance abuse in pregnancy with referrals to the appropriate multidisciplinary team for comprehensive assessment and individualized care in general have been satisfactory.