Substance Abuse in PregnancyStimulant Use in Pregnancy: An Under-recognized Epidemic Among Pregnant WomenSMID, MARCELA C. MA, MD, MS*,†,‡; METZ, TORRI D. MD, MS*; GORDON, ADAM J. MD, MPH†,‡ Author Information *Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine †Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine ‡Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS), Salt Lake City VA Health Care System, Salt Lake City, Utah M.C.S. is supported by Women’s Reproductive Health Research (WRHR K12, 1K12 HD085816) Career Development Program. The remaining authors declare that they have nothing to disclose. Correspondence: Marcela C. Smid, MA, MD, MS, 30 N 1900 E #2B200, Salt Lake City, UT. E-mail: [email protected] Clinical Obstetrics and Gynecology 62(1):p 168-184, March 2019. | DOI: 10.1097/GRF.0000000000000418 Buy Metrics Abstract Stimulant use, including cocaine, methamphetamines, ecstasy, and prescription stimulants, in pregnancy is increasingly common. In the United States, stimulants are the second most widely used and abused substances during pregnancy and pregnant women using stimulants in pregnancy are at increased risk of adverse perinatal, neonatal, and childhood outcomes. In this review, we describe the pharmacology, pathophysiology, and epidemiology of stimulants, summarize the maternal and neonatal effects of perinatal stimulant use, and outline treatment options for stimulant use disorders among pregnant women. Development of effective treatment strategies for stimulant use disorders identified among pregnant women are urgently needed. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.