Pailin Kasemsin, MD¹^,² , Pichita Prasongvej, MD³ , Kornkarn Bhamarapravatana, PhD⁴ , Komsun Suwannarurk, MD³

Objective: To investigate the relationship between inflammatory markers in methamphetamine (MA) abuse during pregnancy and develop a screening tool.

Material and Methods: This was a retrospective cohort study of pregnant women who gave birth at Nakhon Phanom Hospital (NPH), Thailand, between January 2022 and December 2023. Subjects were parturients who delivered at NPH during the study period and obtained MA detection by spot urine sample test at first antenatal care and delivery. Participants with positive and negative urine MA were placed in the study and control group, respectively. Data came from hospital electronic records and were analyzed to create inflammatory markers.

Results: There were 87 and 234 subjects in the study and control groups, respectively. The prevalence of MA during pregnancy was 2.4%. The average age and body mass index of participants were 27.5 years old and 27 kg/m², respectively. The study group had a higher risk of preterm labor than the control group (OR 5.7, p<0.01). Only the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and systemic immune inflammation index (SII) were significant prognostic factors and generated a predictive model (MA score). Predictive model gave a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios at 57.5%, 83.8%, 56.8%, 84.1%, 3.5, and 0.5. respectively.

Conclusion: MA usage during pregnancy affected to preterm delivery. NLR, PLR, MLR, and SII were associated with MA addiction. The MA score was an easy tool to estimate the probability of MA use in pregnancy when MA screening was not routinely performed.

Received 25 September 2025 | Revised 21 January 2026 | Accepted 19 February 2026

J Med Assoc Thai 2026;109(6):513-9

DOI: 10.35755/jmedassocthai.2026.6.03666