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Poster Session 4

Category: Clinical Obstetrics

Poster Session 4

(1266) Perinatal outcomes associated with bupropion use in pregnant persons with Methamphetamine Use Disorder

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author(s)

Sophia Izhar, BS (she/her/hers)

Medical student
Saint Louis University/School of Medicine
Saint Louis University School/St. Louis, Missouri, United States

Coauthor(s)

Michelle R. Petrich, MD (she/her/hers)

MFM Fellow
Saint Louis University/SSM Health
Saint Louis University/St. Louis, Missouri, United States
Justine Keller, MD

Assistant Professor
Saint Louis University/SSM Health
Saint Louis University/St. Louis, Missouri, United States

Presenting Author(s)

Niraj R. Chavan, MD, MPH (he/him/his)

Associate Professor, Program Director - MFM Fellowship, Medical Director - WISH Center, Regional OB Quality Chair - SSM Health
Saint Louis University
Saint Louis, Missouri, United States

Objective:
We sought to evaluate perinatal outcomes associated with bupropion use in pregnant persons with Methamphetamine Use Disorder treated at a comprehensive perinatal substance use disorder (SUD) program.

Study Design:
We conducted a retrospective cohort study of mother-infant dyads who received prenatal care at our specialized perinatal SUD center over a 10-year span from 01/2024 to 03/2023. Demographic characteristics, substance use patterns, psychiatric history, and maternal and neonatal outcomes were abstracted from electronic records and compared across 2 groups—pregnancies with antepartum bupropion exposure and those without. Bupropion exposure included prescribing in the context of established and off-label indications, including perinatal mood disorders as well as tobacco and methamphetamine use disorder. Chi-squared or Fisher’s exact tests were used to compare categorical variables, as appropriate. Statistical significance was set at p≤.05.

Results:
Of 1047 pregnancies reviewed, 121 (12%) were complicated by DSM-V defined Methamphetamine Use Disorder. Of this subset, 19 (16%) were exposed to bupropion. The most frequent dose prescribed was 150mg (63%) and initiation peaked in the second trimester (53%). Although 68% of indications involved mood disorders, in 42% the benefit of improving methamphetamine cravings was cited. In exposed patients, 3 (16%) had an estimated date of delivery (EDD) prior to 2021, and 16 (84%) had an EDD after 2021. Maternal characteristics were similar regarding severity of amphetamine use disorder, substance use disorder history, and psychiatric history (Table 1). Patients with bupropion exposure had similar rates of maternal relapse, overdose, tobacco use, and infant drug screen results (Table 2).

Conclusion:
The increase in bupropion exposure in this cohort since 2021 mirrors practice changes pertaining to use of bupropion for treatment of methamphetamine use disorder in the non-pregnant literature. Further research in a larger cohort is warranted to fully examine the therapeutic potential of this intervention in the context of perinatal methamphetamine use disorder.