Drug abuse in pregnancy. Detection and intervention

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Clinical Toxicology

Background:

• Drug abuse during pregnancy poses significant risks to both mother and fetus.
• Routine screening for substance use in obstetric populations is crucial for early intervention.
• Prevalence rates of drug abuse in pregnant women vary by geographic location and socioeconomic factors.

Purpose of the Study:

• To determine the prevalence of marijuana and cocaine use among pregnant women in a large urban HMO.
• To assess the association between drug use and adverse birth outcomes.
• To report on the development and preliminary experience of an outreach clinic for substance-using pregnant patients.

Main Methods:

• Urine samples from pregnant patients were tested for marijuana metabolites and cocaine.
• Two groups were analyzed: routine pregnancy testing and first obstetric visit urine cultures.
• Data on live births were used to estimate the association of cocaine use.

Main Results:

• Marijuana metabolites detected in 9.1% of routine pregnancy tests; cocaine in 1.3%.
• Urine culture group showed 5.0% marijuana and 0.2% cocaine use.
• Cocaine use was associated with an estimated 1-2% of all live births.

Conclusions:

• Drug abuse, particularly cocaine use, is a significant issue in the urban obstetric population.
• The findings underscore the need for targeted screening and intervention programs.
• An outreach clinic and care process were established to address this public health concern.