Prenatal methamphetamine exposure and fetal death: A retrospective autopsy-based study

Area of Science:

• Forensic pathology
• Toxicology
• Obstetrics

Background:

• Methamphetamine use in pregnancy presents a significant public health challenge.
• It poses severe risks to fetal development and survival.
• This study investigates fetal deaths linked to methamphetamine exposure.

Purpose of the Study:

• To evaluate sociodemographic, autopsy, histopathological, and toxicological findings in fetal deaths.
• To analyze cases with confirmed postmortem methamphetamine detection.

Main Methods:

• Retrospective autopsy-based descriptive study of 28 fetal death cases (2020-2024).
• Inclusion criteria: postmortem fetal blood methamphetamine detection and forensic assessment of exposure/toxicity.
• Integration of macroscopic autopsy, histopathological, and toxicological analyses.

Main Results:

• Mean gestational age: 29.11 weeks; 53.6% female fetuses.
• Maternal factors: mean age 29.85 years, 78.6% primigravida, 78.6% lacked prenatal care.
• Fetal outcomes: 57.1% small for gestational age; histopathology revealed placental infarction, chorioamnionitis, and pneumonia.
• Median methamphetamine: 0.126 mg/L; amphetamine: 0.020 mg/L in fetal blood.

Conclusions:

• Methamphetamine-exposed fetal deaths have serious clinical and medicolegal implications.
• High rates of inadequate prenatal care and home births indicate gaps in identifying at-risk pregnancies.
• Need for integrated obstetric, psychiatric, forensic, and social support systems is emphasized.