Pregnant women who abuse methamphetamine are at increased risk of poor fetal outcomes similar to those who abuse:

• A. Cocaine
• B. Marijuana
• C. Opioids
• D. Alcohol

Answer: (A)

Both methamphetamine and cocaine are potent stimulants that cause significant maternal vasoconstriction and uteroplacental insufficiency. This reduced placental blood flow leads to fetal growth restriction, preterm birth, placental abruption, and increased risk of stillbirth—outcomes seen with meth use and well established with cocaine use. Other substances have different dominant effects (for example, opioids mainly cause neonatal withdrawal, alcohol causes fetal alcohol spectrum effects, and marijuana’s fetal impact is less directly tied to placental vasoconstriction), so the fetal risks from methamphetamine most closely resemble those from cocaine.