Methamphetamine abuse is epidemic in Hawaii, but the extent of use among pregnant women is unknown. We sought to define the prevalence of use during pregnancy. We conducted a cross-sectional study of consecutive births between November and December 1999, and determined that the prevalence of drug metabolites in meconium were fatty acid ethyl esters: 72 (17.1%); cotinine: 33 (7.7%); opiates: 4 (0.9%); delta-9 tetrahydrocannabinal: 1 (0.2%); and methamphetamine: 3 (0.7%). Including three positives discovered solely through forensic testing, the overall prevalence of methamphetamine exposure during pregnancy was 1.4% (6/443). The prevalence of methamphetamine was low compared to the prevalence of fatty acid ethyl esters, reportedly indicative of ethanol exposure, and cotinine, a tobacco metabolite. In Hawaii, more attention should be directed towards alcohol and tobacco use during pregnancy.
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